1993年 · 第106卷第06期

The dynamic changes of 15 parameters (divided into 6 sections in this study) relating to metabolism, platelet function, blood coagulation and hemorrheologic situation under acute exercise loading with the intensity of VO2 max 60% were observed in noninsulin dependent diabetes mellitus (NIDDM) patients. The advantage, safety and feasibility of exercise therapy were discussed.

Using the electrophoretic method, the changes in the catalytic activities of three CK-MM isoforms in multiple sequential serum samples of 12 patients with acute myocardial infarction (AMI) were monitored for 3 days after the onset of chest pain. In post-AMI period, MM3 reached a peak (518.6 U/L) first, on the average 14.0 hours after AMI, followed by MM2 (19.8 h, 640.5 U/L) and MM1 (28.7 h, 641.3 U/L). According to their faster decay from circulation, MM3 had higher fractional disappearance and appearance rates, followed by MM2 and MM1. The MM3/MM1 activity ratio rose beyond the upper limit, found in health subjects, about 3.5 hours after onset of symptom and peaked on an average 10.6 hours after AMI, even earlier than the peaks of all isoforms, CK and CK-MB. On the other hand, our findings indicated these changes in isoform composition can be of value in estimating the time elapsed since the onset of tissue damage; MM3 is the predominant isoform when the tissue necrosis is of relatively recent origin (5-15 h); MM2 is the dominant subband between 15 and 24 hours after AMI, whereas a predominant MM1 band would indicate a significantly longer time period since the injury occurred (24 hours or more). Thus, these characteristics make CK-MM isoforms an earlier and more sensitive indicator of acute release from necrotic myocardium and an effective mean of predicting the time of the onset of AMI.

The elevated estradiol/testosterone (E2/T) ratio had been proved to be a risk factor for coronary heart disease (CHD) in elderly men. We conducted a randomized placebo controlled crossover study on the effects of a new androgenic preparation "Andriol" in 62 elderly men with CHD over a period of 2.5 months. The results showed significant differences between Andriol- and placebo-treated groups at the end of this period: in the former, serum T level was elevated significantly (P<0.001), E2 level was unchanged (P>0.05), E2/T ratio was reduced (P<0.05), angina pectoris (AP) was relieved (total effective rate, 77.4%), and myocardial ischemia in ECG and Holter recordings were improved (total effective rate, respectively 68.8% and 75%). Doppler echocardiography showed that 12 parameters of cardiac function were unchanged in both groups. No obvious side effect was found in those who took Andriol.

Marrows from 58 newly diagnosed acute myelocytic leukemia (FAB-AML) patients were immunophenotyped by flow cytometry with 13 kinds of monoclonal antibodies. Marrows of 53.4% of the patients showed pure myeloid antigen expression (Ly-AML) and 34.5% displayed both myeloid and lymphocyte associated antigen expression (Ly+AML). In general, fluorescence intensity of lymphocyte associated antigen in Ly+AML was weaker than that of myeloid antigen. Myeloid and lymphoid marker cells distributed randomly in DNA-aneuploidy. It took more days to reach the first complete remission in Ly+AML. The aberration antigen expression in AML allows a sensitive detection of minimal residual leukemic cells in complete remission bone marrow and treatment stratification.

Plasmid analysis, restriction endonuclease analysis, antimicrobial susceptibility testing, biotyping, phage typing and outer membrane protein electrophoresis were used to study an outbreak of Salmonella typhimurium infection at a newborn nursery. Seven out of the 12 neonates had positive blood cultures for S. typhimurium, and 2 of them died of severe sepsis. Thirty epidemic strains of S. typhimurium belonging to phage type 12 had the same plasmid profiles (98.0, 6.7 and 3.8 Kb) and identical restriction digest patterns (23.0, 20.4, 15.0, 9.6, 8.2, 7.4, 5.8, 4.3, 3.8, 2.0 and 1.8 Kb) which were different from those of the 2 non-epidemic strains. Laboratory data suggested that the source of the infection was the index patient's mother who had a slight diarrhea; the mode of transmission was most likely due to the transfer of organisms from infant to infant by the contaminated hands of nurses during milk feeding.

A study on the incidence and high risk factors of hypothermia in the newborn was carried out in a period of four months (Nov. 1988-Feb. 1989) in 6 counties of 3 provinces. Totally 14,809 newborns were studied, in whom 100 cases were found to be ill with sclerema, having an incidence of 6.7%. Gestational age, body weight, low room temperature, improper methods of thermopreservation during delivery and asphyxia are determined as the most probable high risk factors, in which gestational age and body weight are negatively correlated with the contraction of the disease. It suggests that the prevention of prematurity and asphyxia, and promotion of thermopreservation during delivery should be helpful in preventing sclerema of newborns.

Microsurgical tubocanalization was done in 412 patients. 278 women had the operation before the end of December 1987 and were followed up. The overall intrauterine pregnancy rate was 81.3% (92.86% for isthmus-isthmus anastomosis and 87.5% for ampulla-ampulla anastomosis). Two patients had ectopic pregnancy which was followed by term pregnancy subsequently. The factors affecting operative results were analyzed.

Serum pregnancy specific beta 1 glycoprotein (SP1), human placental lactogen (HPL) and urinary estrogen/creatinine (E/C) ratio levels were determined to study their clinical significance in predicting low birth weight (LBW) in women with normal pregnancy and patients with LBW. The results showed that the sensitivity of urinary E/C ratio was better than that of serum SP1 and HPL, and was increased gradually with the reduction of fetal weight. The specificity in predicting LBW decreased gradually with the increase of serum SP1 and HPL levels and urinary E/C ratio. When serum SP1 level was less than 50 mg/L, HPL less than 2.0 mg/L, and E/C ratio less than 10, their specificity could increase over 90%. It is suggested that multi-indexes measurement would improve the accuracy for predicting LBW. We conclude that SP1, HPL and E/C ratio measurement could be an useful index for predicting LBW.

One hundred thirty-one patients with hepatocellular carcinoma were subjected to permanent hepatic artery embolization with dextran microspheres (G-25, 50-150 μ). Dextran hepatic artery embolization is indicated for massive, nodular or multinodular hepatocellular carcinoma with total bilirubin less than 3 mg/dl, serum albumin greater than 3.0 g/dl, tumor involvement area less than 50% or without involvement of the main portal vein. Following hepatic angiography a catheter was inserted superselectively into the hepatic artery feeding the tumor. Adriamycin (60-80 mg) or cisplatin (60-100 mg) was infused immediately before embolization. Under fluoroscopic guidance, 0.3-0.5 g of dextran microsphere embolizer permeated with 10 mg of mitomycin C was infused into the feeding artery through the catheter. Dextran microspheres caused marked homogeneous and distal micro-arterial embolization, especially in the arteriole with a caliber of about 100 μ. Dextran microspheres were not resorbed in a period of 16 weeks in humans, thus reducing or preventing the formation of intrahepatic and extrahepatic collaterals after hepatic artery embolization. Dextran hepatic artery embolization was very effective for not only main tumor but also daughter foci or metastatic nodules, as was confirmed histologically in 8 cases. The 1-year, 2-year and 3-year survival rates were 57.0%, 31.4% and 24.2% respectively.

One hundred eight-two patients underwent percutaneous lumbar discectomy using a new nucleotome system. The curative and effective rates were 84.6% and 89.6% respectively, without serious complications. To overcome the difficulty of puncture and cutting the nucleus pulposus at L5-S1 interspace, an efficient approach was undertaken to drill through the iliac wing at L5-S1 using a self-designed circular drill so that the nucleotome could safely reach L5-S1 disc, the successful rate was 100%. By varying the distance and angle of puncture, it is possible to treat central type of lumbar disc herniation, thereby expanding the indications for this procedure.

The neutrophils in 2 patients with atopic disease were studied. Ultrastructurally, a number of abnormal azurophilic granules (AG) with low electron-density (Case 1) and secondary lysosomes with "myelinoid membranes" figures (Case 2) were found. Myeloperoxidase (MPO) and acid phosphatase activity were detected by light cytochemical techniques, and showed significantly low values. The deficiency of MPO and abnormal distribution of AG were also demonstrated by electron microscopic cytochemical technique. The neutrophils from the parents revealed changes similar to the patients. This study suggests that since genetic partial deficiency of neutrophil AG enzymes existed, the phagocytosed substances were only partially degraded, leading to accumulation of substances with antigenicity, and became trigger event of atopic disease.