1989年 · 第102卷第11期

Human immunodeficiency virus (HIV) is now considered as the causative agent of acquired immunodeficiency syndrome (AIDS). A high risk of AIDS has been reported among patients with hemophilis who received lyophilized commercial factor VIII and IX concentrates of American origin. At a prevalent survey from September to December 1985, HIV antibodies were found in all four patients with hemophilia treated with the batch number W87307, 955 I.U. of American commercial factor VIII concentrate supplied by Armour Pharmaceutical Company, USA. One of the sero-positive patients developed AIDS-related complex (ARC) and died of cerebral hemorrhage. The other three sero-positive patients had abnormalities in cell-mediated immunity. Of them two developed left lumbosacral radiculopathy and hemorrhagic herpes zoster and one remained well so far.

Since March 1978, conservative laryngopharyngeal surgery has been used in the treatment of carcinoma of the pyriform sinus at this hospital. For pharyngeal reconstruction, cervical skin flap, deltopectoral flap, free microvascular bowel transfer, and pectoralis major myocutaneous flap and gastric pull-up transfer were used. The remaining part of the larynx was repaired with cervical skin flap, sternohyoid myofascia, epiglottis or remnant of epiglottis for complete rehabilitation (phonation, deglutition protection and respiration) or partial rehabilitation (phonation and deglutition protection) of laryngeal functions. 47 patients with carcinoma of the pyriform sinus were treated, and fairly good results were obtained. The 5-year survival rate was 41.7%, and the 3-year survival rate 50%. The laryngeal function restored completely in 31 patients and partially in 16. It is suggested that preservation of the unaffected part of the larynx is feasible both for eradication of tumor and preservation of laryngeal function.

Two patients with congenital coronary artery fistula were treated surgically at our hospital in 1987. The fistulae originated from the left coronary artery. One patient was treated by direct ligation and the other by suture from within the left ventricle under cardiopulmonary bypass. The diagnosis and method of surgical treatment were discussed.

Both alpha-1-antitrypsin (AAT) and alpha-1-antichymotrypsin (AAC) in serum were investigated in various liver disease. Serum levels of AAT and AAC in normal controls were 293.3±37.9mg/dl and 119.6±18.9U/ml, respectively. Both AAT and AAC were significantly higher in 75 patients with primary hepatocellular carcinoma (PHC) than in patients with acute viral hepatitis, chronic hepatitis, liver cirrhosis as well as normal controls. In a cut-off value of more than 400 mg/dl AAT showed a sensitivity rate (SS) of 74.7%, specificity (SP) of 97.3%, positive predictive value (PV+) of 86.2%, negative predictive value (PV-) of 95.5% and a total accuracy of 93.3% for diagnosing PHC. In a cut-off value of more than 157 U/ml, the corresponding figures for AAC were 68.0%, 96.7%, 86.4%, 90.6% and 90.0%. If the increased levels in one or both tests are positive, the combined positive rate is 80.0% in PHC. In 11 PHC cases with serum alpha-fetoprotein (AFP) less than 50ng/ml, the positive rate of AAT and AAC were 72.7% and 81.8%, respectively, compared to corresponding figures of 71.7%, and 65.2% in 46 cases of PHC with more than 50ng/ml of AFP. It shows that combined assay of both serum AAT and AAC has a complemental value in the diagnosis of PHC, especially in patients without increased AFP.

Three murine monoclonal antibodies COCL66-9, COC183A5 and COC183B2 were raised against human epithelial ovarian adenocarcinoma with soluble antigens. The monoclonal antibodies were stable after culture and stored under 80C for 9 to 20 months. The subclass and titer were all examined and the reactivity were tested on various paraffin embedded tissue sectionsm by immunoproxidase stainings. The results of positive staining against ovarian epithelial adenocarcinoma were 77.7%, 87.2% and 75.6% for COC166-9, COC183A5 and COCL83B2 respectively. Human ovarian carcinoma xenograft in nude mice were radioimaged after 131I-COC183B2 administration. Gamma scintigraphy demonstrated specific localization of the radiolabeled monoclonal antibody on these tumors. The results showed a bright future for immunodiagnosis and immunotherapy.

Phagaquosonographies (PASG) of 100 normal subject and 223 patients with cardiac cancer (CC) were analyzed. The apparatus was self-designed and self-manufactured. The wave patterns and the pre-ejection period and other 8 quantitative indices in PASG were compared and patients with CC were found to have abnormal levels (P<0.01). The phagaquosonograms in 82 patients with esophageal, gastric or cardias (non-cancer) diseases served as controls. The PASG showed positive results in 97.3%, suspicious in 2.3% and negative in 0.4% of CC cases and 100% negative in the normal subject. It was 1.2% positive, 8.5% suspicious and 90.3% negative in the esophageal, cardiac or gastric non-cancer diseases. PASG has high sensitivity (97.3%), and typical characteristics (98.8%). It is shown that this method can be used in screening, diagnosis, differential diagnosis and prediction of prognosis of cardiac cancer.

The mitotic activities of various cellular components of callus tissues in different periods after tibial fracture of rat were studied with 3H-thymidine labeling and electron radioautographic method. Silver grains were accumulated over the nuclear areas of mesenchymal cells, monocytes, macrophages, endothelial cells of capillaries, fibroblasts, chondroblasts and chondrocytes, as a result of incorporation of the labeling material during their mitosis. Although osteoblasts and osteocytes could not undergo mitosis, they also revealed silver grains over nuclear areas because of their derivation from the mesenchymal cells or osteogenic cells.

This paper analysed 102 strains of adenovirus types 3 (Ad3) and 7(As7) causing infant pneumonia from 1976 to 1988 in northern China. Two genotypes of Ad7, 7b and 7d, were identified by using restriction endonucleases, BamHI, BgLI, SmaI, XbaI and HindIII. 3genotypes of Ad3, 3I, 3II and 3III, were identified by using BgLII and BamHI. Of 56 Ad7 strains, 34 were 7b (76.8%) spread over last 10 years; 13 7d (23.2%) occurred from 1982, together with 7b. Of 46 Ad3 strains, 42 3I (91.3%) spread over these years. Ad3I and Ad7b were the dominant genotypes. The results indicated that Ad7d tended to increase with time from 1982. It is possible that Ad7d will become dominant genotype and replace Ad7b.

From November 1986 to September 1987, 27 253 newborns were screened for congenital hypothyroidism (CH) with Time-Resolved Fluoroimmunoassay (TR-FIA) for TSH concentrations in specimens of dried blood spots on filter paper. Specimens were obtained in 12 hospitals by heel pricking of the babies 48-72 hours after birth. The specimens with TSH concentration higher than 20Uu/ml were retested, and the babies were called back for confirmation of CH by TSH, T3, T4, Tg serum radioimmunoassay etc. and bone-age radiography if the repeated tests were positive. In the present series, 337 specimens were retested (1.23%). Altogether 25 babies were recalled (0.09%) and CH was confirmed in 5 cases, giving a screening incidence of 1:5 450. In addition, one case failed to respond to the recall because of a wrong address. TR-FIA or DELFIA (pharmacia-LKB) is non-radioactive and does no harm to man and the environment, and is thus feasible in ordinary laboratories. The method is sensitive and the results are reproducible, with a precision of 1.4μm/ml. Being rapid in terms of measuerement time, it is suitable for mass screening.

Fibrous cortical defect (FCD) is a local disturbance of ossification, more commonly seen in metaphysis of tubular bones of growing children, with prcdilection site around the knee joint. The roentgenographic appearances of 6 patients with FCD werc characterized by an eccentric round or oval-shaped translucent area with lobulated sclerotic border, and the normal surrounding bone. The bony cortex was characterized by a superficially depressed defect which disappeared spontaneously and was labile. Multiple lesions were usually symmetric. Some patients had familial tendency.

In the past few years, a great deal of departments have been achieved in both research and clinical work in the field of orthopaedics. This is a brief review of the chievements in the related basic research, spinal surgery, hand surgery and bone oncology in China.