The imaging quality of the portal vein was obviously improved with prostaglandin E1 (PGE1) indirect portal vein digital subtraction angiography (DSA) in 23 cases. The time-density curve showed that the occurrence rate of opposite hepatic blood flow of splenic vein (SV) was the highest (17.4%). The total visualization rate of the left gastric vein (LGV) was 78.3%, and the visualization rate of the short gastric vein (SGV) was 36.4%. 38.9% of the LGV and all the SGV were visualized with indirect portal vein DSA through SA. Indirect portal vein angiography through superior mesenteric artery and that through splenic artery were of equal importance. In portal hypertension patients with hemorrhage of the digestive tract, when LGV and SGV could not be visualized in PGE1 indirect portal vein DSA, the possibility of non-varices vein bleeding should be considered. When opposite hepatic blood flow with obvious dilation appeared in LGV and SGV, devascularization of the pericardial blood vessels would be justifiable.
We evaluated the effect of vasoactive intestinal peptide (VIP) receptor, a brain-gut peptide receptor which is capable of exciting central neurons, on the pathogenesis of hepatic encephalopathy (HE). By means of radio-ligand binding assay, VIP receptors in the crude synaptosomal membranes of rat brains were investigated in rat models with HE induced by partial hepatectomy following carbon tetrachloride intoxication and in controls. The binding to the VIP receptor was studied, with 125I-VIP as a radioligand. Scatchard analysis of the binding data was linear, yielding a dissociation constant (Kd) of 0.28±0.01 nM and a maximal binding capacity (Bmax) of 9.56±0.29 fmol/mg of protein in HE rats. Only decreased Bmax values were observed (P<0.002), while the Kd values were statistically unchanged (P>0.20) in HE rats as compared with the controls. The results suggest that the changes of VIP receptors in the brains of HE rats play a significant role in the pathogenesis of HE. The mechanism of HE induced by the alterations of VIP receptors in the brains was discussed.
Adeno-associated virus vector (AAV), a non-pathogenic integrating vector, can integrate on chromosome 19 in humans. But its gene transfer efficiency is quite low. In this study we combined adenovirus (Adv-5) capsid protein or the Fiber protein of Adv with liposome, termed adenosome (adenovirus protein-cationic liposome complex). This complex can bring AAV/CMV-LacZ to the endothelial cells, and improve the efficiency of gene transfer. It may be a novel, specific, stable and safe gene delivery system and will be widely used in human gene therapy.
From 1984 to 1990, six patients with histologically and endocrinologically proven ectopic ACTH syndrome were treated in our department. The lesion in five patients was clinically evident, but in the other was occult. All lesions were located within the chest. Four were thymic carcinoid and the other two were bronchial carcinoids. Most of the patients had typical clinical manifestations of Cushing's syndrome. Laboratory tests including histopathological examination confirmed the diagnosis of ectopic ACTH syndrome. The treatment consisted of surgical removal of the mass supplemented by radiotherapy. The results showed that after treatment all patients had satisfactory remission. Two bronchial carcinoid patients have been living for 40 and 88 months respectively without recurrence. Among 4 thymic carcinoid patients, only one has been living with no tumor for 34 months. One patient had recurrence and the other 2 died 32 and 50 months after the treatment respectively. However, the symptoms of two thymic carcinoid patients had not been relieved at all until radiotherapy was given. This paper discusses the method, dose and indications of radiotherapy. It should be pointed out that the prognosis of bronchial carcinoids is good while that of thymic carcinoids is relatively poor.
A meiotic study of human semen specimens was carried out in 60 cases. Among them, 20 were normal controls, 20 suffered from infertility, and 20 had a history of recurrent spontaneous abortions. Of the cases of infertility and abortion, 50% were found to have numerical and/or structural chromosomal aberrations in spite of the normal blood karyotype. It is suggested that chromosomal aberrations may be the cause of sterility and abortion. The success rate of semen chromosome G-banding in the infertility, abortion and control groups was 70%, 55% and 25% respectively. The semen samples of three cases of heterozygous carriers with reciprocal chromosomal translocation were also studied. The ring quadrivalents were identified in all cases. The results may explain the recurrent abortions in these patients.
A case-control study of laryngeal cancer was conducted in Liaoning Province between January 1991 and April 1992 among 100 subjects with newly diagnosed cancer and 100 controls. The results of one factor analysis, odd ratio (OR), and conditional logistic regression indicated that smoking was the first significant risk factor for laryngeal cancer with an OR value of 16.8. Tobacco smoking ranked the first with an OR value of 30.4. Other factors such as alcoholic indulgence, insufficient intake of vegetable and fruits in winter and spring, air pollution in room and working environment, and fatigue of vocal cords were closely associated with the occurrence of laryngeal cancer.
The morphometric analysis of the spinous cell in 16 specimens of oral submucous fibrosis (OSF) was made by using interactive image analysis system (IBAS-II). 19 parameters of the size and shape were chosen, and compared with normal mucosa, leukoplakia, dysplasia and carcinoma. The results indicated that the cell dimensions (area, perimeter, all kinds of diameter) and nuclear cytoplasmic ratio in OSF were between normal mucosa and dysplasia as well as carcinoma. The former showed a progressive decrease (P<0.01), and the latter showed a progressive increase (P<0.01). The dimensions of the nuclei did not show considerable differences among the groups (P<0.05). A series of discriminant functions had been developed with stepwise discriminant analysis, the agreement ratio for OSF was 93.75%. The decrease of cell area and the increase of nuclear cytoplasmic ratio could reflect a malignant progress. The cell morphometric model could discriminate OSF well from other groups, suggesting that the change of the epithelium in OSF appearing in the spinous cell is specific itself.
Chen Minhua, Dong Baowei, Zhu Qiang, Li Jianguo, Wang Bin, Wang Min, Kiyosi Choiji, Yukihiko Sato, Riwa Kishimoto, Nobuyuk Fujita
CHINESE MEDICAL JOURNAL1995年 108卷 05期
DOI: 10.3760/cma.j.issn.0366-6999.1995.05.113
摘要
42 cases of dilatation (7-15 mm) of extrahepatic bile duct after ceosunin injection (cholagogic method) were observed ultrasonographically. Among the 18 cases of testified obstructive lesions of the bile duct, 13 (72%) showed widening of the bile duct with an increase of calibre from 9.8 mm to 11.7 mm, 3 (16%) had no obvious change, and 2 (12%) shrank. Among the 24 cases of non-obstruction 22 (92%) shrank with a decrease calibre from 9.6 mm to 6.3 mm, and 2 (8%) showed no obvious change. After receiving cholagogue, 9 cases of periampullary carcinoma in the obstructive group were confronted with widening of the bile duct calibre. After longitudinal and transverse rotation scanning method was used, 8 of the 9 cases had their tumor mass visualized. Combined cholagogic and rotation scanning methods raised the lesion manifestation rate of lower bile duct from 41% to 88%. A dilated bile duct unable to show shrinkage of calibre after cholagogue injection is believed to be a criterion for judging the presence of a suspicious case of bile duct obstruction. This criterion has a sensitivity of 89%, specificity of 92%, and accuracy of 90%.
A comparative study of the biochemical and biophysical characteristics of myocardial mitochondria was conducted in 16-weeks-old male stroke-prone spontaneously hypertensive rats (SHRsp) and normotensive Wistar-Kyoto control rats (WKY) (n=6-12). Cardiac and ventricular weights of SHRsp were significantly higher than those of the WKY group. The average amounts of mitochondria (Mit) and sarcoplasmic reticulum (SR) proteins isolated from the ventricle of SHRsp were 37% and 25% greater, respectively, when compared with those of WKY. Mit cytochrome c oxidase activities (μmol/min/mg) were 4.63±0.71 for SHRsp and 5.55±0.50 for WKY myocardium (mean±s), so that the activity of the former was significantly reduced by 17% (P<0.01). Mit Ca2+, Mg2+-ATPase activity (μmol/min/mg) of SHRsp was 24% lower than that of WKY myocardium (P<0.01). The fluorescence polarization of myocardial Mit membrane labelled with DPH (1, 6-diphenyl-1, 3, 5-hexatriene) in hypertensive rats was not different from that in control rats. The spectra of intrinsic protein fluorescence in 300-380 nm at an excitation wavelength of 290 nm were also identical in the Mit or SR between SHRsp and WKY myocardium. An ultrastructural analysis showed that there were more new-born Mit with smaller volumes and an increased number of isolated Mit in vitro from SHRsp myocardium, while there were larger Mit volumes isolated from WKY myocardium. These results demonstrated the disorder of mitochondrial energy metabolism in hypertrophied myocardium from SHRsp, which may be involved in the abnormality of myocardial calcium metabolism.
In 31 patients with intracranial germinoma who received radiotherapy, 15 were operated on, and 13 were treated with CSF shunt (7) and external ventricular drainage (6). After radiotherapy, clinical symptoms were improved in 93.5% of the patients. Follow-up of 16 patients for 2 to 14 years showed better results. We consider that initial treatment with radiotherapy may be appropriate for germinomas because of its high radiosensitivity. If hydrocephalus developed, external ventricular drainage combined with radiotherapy was performed, but shunting operation might be avoided because of potential peritoneal seedings of germinomas. In addition to chemotherapy, re-irradiation is an effective method for recurrent germinoma.
Liu Minghui, Zhu Langbiao, Wang Dongqing, Yu Yifei
CHINESE MEDICAL JOURNAL1995年 108卷 05期
DOI: 10.3760/cma.j.issn.0366-6999.1995.05.121
摘要
A 7-year-old girl with an anomalous origin of the left coronary artery from the pulmonary artery restored connection of the left coronary artery to the ascending aorta by aortocoronary bypass graft. Aortocoronary bypass grafting was performed with a vascular prosthesis. Postoperative angiography showed a patent left coronary artery without narrowing or kinking. Clinical improvement was rapid and the left ventricular function recovered completely.
