1989年 · 第102卷第10期

Catecholamine crisis, one of endocrine emergencies. has a dramatic clinical manifes- tation. Excess catecholamine may sometimes Jead to disorder of gastrointestinal function. We report herein a case of adrenal medulla hyperplasia (AMH) complicated by catechol- amine acute abdomen (CAA) and its clinical characteristics and special considerations of treatment.

Fructus Schizandrae (FS) is a well–known Chinese herb which has been widely used in ancient China. During recent decades, it has been found to be effective in viral and chemical induced hepatitis. In this paper, we report the studies on the chemical constituents and pharmacological actions of FS on mice liver. The results indicated that FS and its several components can mainly protect liver from injury induced by toxic substances such as CCl4; they have anti-oxidant activities against oxygen free radicals; FS and four components have inducing action on liver cytochrome P-450; they also promote certain anabolic metabolism such as serum protein biosynthesis and glycogenesis. All these activities would be of importance in the protection and repair of the injuried liver cells. The clinical use of FS is also presented.

Low-dose ionizing radiation caused definite stimulation of immune reactions both in humans and mice. The PFC reaction in response to SRBC immunization and the NK activity of the splenocytes were significantly enhanced after low-dose whole body irradiation. Activation of the T lymphocytes, especially the TH, with increased production of IL-2, might be a critical step in the whole process of immunoenhancement. A single dose of 75 mGy X-rays caused significant lowering of hypothalamic M-Enk content as well as serum corticosterone level. The increased serum testosterone level would exert an inhibitory influence on the CRF-ACTH-CS system to keep the blood corticosterone at a lower than normal level which might facilitate the immune reactions in the SRBC-immunized animals. The increased catecholamines in the spleen would probably reinforce this effect resulting in immunoenhancement. Low-dose ionizing radiation caused increased repair of the genetic material at both the molecular and subcellular levels. The UDS of human and murine lymphocytes was augmented by single or continuous low-dose irradiation. The stimulation of DNA polymerase activity might be responsible for such effects. Exposure to very small doses of low LET radiation could induce in different tissues an adaptive response which alleviated chromosome damage caused by subsequent larger dose radiation. Such an adaptive response could be induced both in vivo and in vitro in different animal species. The induced adaptive response faded away after 3 cell cycles could be re-induced by a second exposure to low-dose radiation. The mechanism of the inductive process needs further study. Data presented in the present paper strongly speak for the existence of radiation hormesis as a universal phenomenon.

To study the relationship between clinical manifestations and coronary anatomy and morphology, coronary angiography was performed in 20 patients with chronic stable angina (Group I), in 18 patients with unstable angina (Group II), and in 20 patient with previous myocardial infarction (Group III). Although the site and extent of coronary artery disease were similar among the groups, coronary morphology differed considerably, with a concentric lesion occurring in 70% of Group I patients and an eccentric lesion in 62% and 63% of Group II and Group III patients, respectively. The study suggests that coronary lesion morphology may form an anatomic basis in determining clinical manifestations for patients with coronary artery disease. An eccentric coronary stenosis may be useful in identifying high-risk patients.

In a baseline survey of 4936 school children aged 6-16 years, 199 children with systolic blood pressure (SBP) values equal or greater than the 95-th percentiles for age and sex were chosen as the hypertensive group(HBP), and were matched for age and sex with 197 children with SBP from the 5-th through the 50-th percentiles as the control (normotensive) group (NBP). For both groups the intra-RBC and plasma sodium and potassium contents, 8-hour night urinary sodium, potassium and creatinine excretions for three days, and an oral saline-water load test were performed. The results show that (1) intra-RBC potassium level in the HBP was lower that that in NBP. The level in those with positive hypertension family history (FH+) was lower than that with negative (FH-). The intra-RBC potassium contents correlated inversely with diastolic BP. No correlation between intra-RBC sodium and BP was found; (2) Plasma sodium concentration in HBP was much lower than that in HBP. No difference was found between the FH+ and FH- in the plasma sodium concentrations; (3) Mean 8-hour night urinary potassium excretion expressed as mmol/g creatinine, was lower in HBP than in NBP; (4) After the saline load test the 4-hour urinary sodium excretion was significantly higher in HBP. Of those children with FH- the 4-hour sodium excretion in HBP was higher than that in NBP, but no significant difference was found between HBP and NBP of the FH+ children in the 4-hour urinary sodium excretions. It is believed that the above electrolyte changes in the children with their blood pressure at higher percentile levels represent an abnormal relation between potassium and arterial blood pressure in the earlier stage of hypertension evolution, as well as the early changed natriuresis of the kidneys.

The life table method is introduced for describing the relationship of smoking amount to prevalence rate of hypertension. The smoking level at different sex groups are collected and grouped according to their cumulative smoking amount. Using the total number of peasants, and the number of hypertensive in each group, one is able to calculate the probability of occurrence of hypertension for each dose group as well as for each cumulative dose group, which indicated that there was a dose-effect curve in estimating the relationship between the cumulative smoking and the probability of hypertension, and females presented a significantly higher probability of hypertension than males in same smoking level.

The changes in endogenous superoxide dismutase (ESOD) during myocardial ischemia and reperfusion and the efficacy of oxygen free radical scavengers in myocardial protection were investigated in an isolated heart model connected with the recirculating nonpulsatile perfusion circuit. Subjected to a 2-hour period of global ischemia (27 C), the heart was reperfused with 37 C oxygened diluted auto - blood for 60 minutes. Superoxide dismutase plus catalase was added into the cardioplegic solution and reperfusates. ESPD activity was measured by pyrogallol method. The results of the experiment showed that ESOD activity after ischemia and reperfusion was decreased and the addition of oxygen free radical scavengers (SOD and CAT) to the cardioplegic solution and the reperfusates greatly reduced the leakage of myocardial enzymes, coronary vascular resistance, and the ultrastructural damages of the myocardium. These results suggest that the use of SOD and CAT may inhibit myocardial reperfusion injury by scavenging oxygen-derived free radicals.

Two patients with Zollinger-Ellison Syndrome were diagnosed and treated in PUMC Hospital, the primary tumors were found in the stomach. On sectioning of the gastrectomized specimens, 85 tumors ranging from 0.1 to 1.0 cm in diameter were disclosed in Case 1, and a large ulcero-infiltrative carcinoma-like tumor in Case 2. Both tumors had already metastasized to regional lymph nodes and/or liver. Tumor cells in both cases exhibited gastrin, NSE, GH and hCG immunoreactivity immunocytochemically, and abundant neurosecretory granules of 100-250 nm in diameter under electron microscope. The clinicopathological, immunocytochemical and ultrastructural findings of tumors from these two cases met the criteria of primary malignant gastrinoma of the stomach.

The DNA content of 12 small hepatocellular carcinomas (SHCC,<3 cm in diameter) and 26 large hepatocellular carcinomas (LHCC) was quantitatively determined by means of TV–image analysis. The results showed that 8 patients (66.7%) with SHCC had DNA stem lines in diploid (2C), and 24(92.3%) with LHCC had DNA stem lines in aneuploid (AN) (P<0.01). The incidences of tumor capsule breaking and cancerous thrombosis were 165 and 20% respectively in SHCC, significantly lower than 84% and 80% in LHCC (P<0.01). The 5-year survival rate was 75% in patients with SHCC after operation, much higher than 46.2% in patients with LHCC. No relations were found between DNA content, tumor size, pathological grading and serum AFP valurs of HCC. The results suggest that SHCC less than 3cm in diameter reflects the early changes of biological characteristics; HCC of 3 cm in size may be at an important period when the changes of DNA stem lines and biological characteristics would occur; SHCC is possible to be determined by steam AFP values; and that the survival rate of the patients can be further improved by early finding and treatment of SHCC less than 3cm in diameter.

Fifty human fetal pancreases of 4-6 months gestation obtained from legal abortions were microencapsulated with alginate, poly-lysine after culture for 4-7 days. The microcapsules were studied morphologically and functionally. Immunocytochemical staining for insulin indicated B-cells were morphologically intact at 48 days. Insulin and C-peptide of the culture medium measured with radioimmuno-assay (RIA) showed that the microcapsules still retained the function of insulin secretion after culture for 25 days. There was no statistical difference when compared with noncapsulated tissues. No exocrine function was detected as evidenced by the amylase determination. We conclude that microencapsulated human fetal pancreatic tissues retain viability in culture for more than 25 days and can be used as transplants in the treatment of diabetes mellitus.

Of the 166 patients receiving autogenous mandibular bone grafts during 1972-1987, 55 were used for repair of mandibular bone defect, 67 for correction of maxillofacial malformation and 44 for reconstruction of temporo-mandibular joint. Follow-up showed that 155 patients had satisfactory results after operation.