1995年 · 第108卷第12期

Percutaneous balloon mitral valvoplasty (PBMV) and radiofrequency catheter ablation (RFCA) have been used in the treatment of mitral stenosis (MS) and supraventricular tachycardia. The techniques of PBMV and RFCA yield better results with the development of interventional cardiology, but there is no report about PBMV performed simultaneously with RFCA in the same patient. Seven patients with mitral stenosis and Wollf-Parkinson-White (W-P-W) Syndrome were successfully treated with PBMV and RFCA by transseptal methods. LA, LAP, mPG and mPA were decreased from 43.4±4.6mm, 21.8±6.8mmHg, 21±7.7mmHg and 45.7±16.5mmHg to 39.2±3.7mm (P<0.05), 12.7±4.5mmHg, 12±3.7mmHg and 32.3±9mmHg (P<0.01). MVA was increased from 0.96±0.33cm2 to 1.7±0.80cm2 (P<0.01). delta wave disappeared in 12-lead surface EKG and SVT could not be induced in electrophysiological study after the treatment. The overall time of the procedure for this series was 93±34 minutes and fluoroscopy time was 23±7 minutes on the average. Radiofrequency energy applications were 3±2 times each procedure. PBMV and RFCA are safe and highly effective in the treatment of MS and W-P-W syndrome. The results in the present study proved the feasibility of the combined use of PBMV and RFCA. We prefer a first choice of PBMV and then RFCA in order to avoid aggravation of the hemodynamics due to mitral stenosis. The results also showed that of overall procedure and fluoroscopy only took a short time for this series. We suggest that it could be used as a routine method for the treatment of mitral stenosis complicated by W-P-W syndrome.

Graft rejection is a baffling problem in organ transplantation which has so far no successful resolution. Present antirejection therapy is expensive, toxic, susceptible to infection, oncogenesis and atherosclerosis. With the use of 2 extremely histoincompatible strains of rats as model, it was found that when six donor splenocytes preconditioned by an extract from the culture medium of streptomyces caespitosus were injected into the host, after 2 weeks immune tolerance heterotopic transplanted donor hearts could survive normally more than 100 days without using any anti-rejection drug. Their mean survival time was 141.4±2.56 days, while that in the control group was only 11.7±3.48 days (P<0.005). Thus, the present research offers some bright prospects in the area of organ transplantation.

The study was proceeded on the mRNA expression of the GLUT-1 and GLUT-4 gene in the alloxan-induced diabetic rats by the method of dot-blot hybridization analysis. The results showed that the levels of the GLUT-4 mRNA expression were reduced in the muscle tissue of the diabetic rats while its levels in the same tissue of insulin treated diabetic rats increased. It was suggested that the reduced GLUT-4 mRNA expression which could affect its posttranslational products may be one of the causes of the insulin resistance.

Three gena of mosquitoes were fed with human blood infected with hepatitis B virus (HBV) artificially. When blood in the stomach was completely digested, mosquitoes were used to bite monkeys Tupaia Belangeri. A month after biting, venous blood samples were taken from the monkeys to detect serum HBsAg, HBeAg, Anti-HBs and Anti-HBc. Among 29 test monkeys, 9 were HBV infective serum markers positive. In 4 of 16 test monkey liver biopsies, acute inflammatory changes were found with Hematoxylin-Eosine staining. In the hepatic cells, HBsAg and HBcAg were detected by immunohistochemical double-labeling assays, and HBV-DNA was also positive by in situ hybridization in monkey liver sections. These results provided an evidence for the possibility of transmission of HBV through mosquitoes and suggest its epidemiological significance in mosquito infested areas.

Since 1979 we have treated 149 patients with duodenal ulcer by extended parietal cell vagotomy (EPCV). Electron microscopy of parietal cells from gastric body mucosa and gastric acid secretory test were carried out in 22 randomly selected patients before and after EPCV. It was shown that before EPCV the ultrastructure of parietal cells presented the feature of vigorous section identical to the hyperfunctional secretion of gastric acid. The ultrastructure of parietal cells presented the feature of acute depression of secretory function, which was identical to a significant reduction of secretory function of gastric acid 0.5-6 months after EPCV. Two to 10 years after operation, however, especially over 10 years after EPCV, the ultrastructural changes of parietal cells gradually returned to normal, but gastric acid secretion remained at a low level, without preoperative secretory capacities. The results of this study provide a histological basis for the application of extended parietal cell vagotomy in the treatment of duodenal ulcer and its complications.

We analyzed the data from seroepidemiologic survey of anti-HTLV-I serum antibody (HTLV-1 Ab) and 16 adult cases of T-cell leukemia (ATL) in China (1984-1994). The results showed that the positive rate of HTLV-I Ab of the population of China was 0.54%, the birth or residence places of HTLV-I carriers and all the patients with ATL were mainly distributed in the coastal provinces and the northeast China, and a small endemic area of HTLV-I and ATl was found in Fujian Province (HTLV-I Ab positive rate, 2.1%). The HTLV-I in China may be transmitted from Japan or originated from China. The clinical characteristics of the cases included onset in adulthood; frequent skin lesions, lymphadenopathy and hepatosplenomegaly; no mediastinal mass; the ATL cells from peripheral blood with polymorphism nuclei and mature T cell immunophenotype HTLV-IAb positive in most of the cases tested (5/8); mostly acute type; with a median survival period of 3.5 months.

The cholangiopancreatographic findings in 22 patients with pseudotumorous pancreatitis (PTP) were evaluated on the basis of endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC). All patients were found with a focal mass in the pancreas based on the findings of ultrasound and/or CT. However, only one patient had been diagnosed correctly as suffering from chronic pancreatitis by ERCP. Normal pancreatic duct was found in 4 patients. There were five patients having abnormal pancreatic ducts, but findings of ERCP could not provide definite diagnosis. In the remaining 12 patients the abnormalities of pancreatic and/or bile ducts were strikingly similar to those found in pancreatic carcinoma. Double duct sign was also seen in one patient. All these 12 patients were incorrectly diagnosed as having pancreatic carcinoma. It is concluded that ERCP/PTC has little value in detecting PTP.

The 50 g oral glucose challenge test (50gGCT) was performed on 622 pregnant women, and 75 g oral glucose tolerance test (75gGTT) was further done on subjects with screening tests value of>or=7.78 mmol/L. The results showed that there were 16.56% (103/622) women with screening value of>or=7.78 mmol/L, among whom, 32 were identified as having gestational impaired glucose tolerance (GIGT) and 12, gestational diabetes mellitus (GDM) by confirmatory test of 75gGTT. The sensitivity of 50gGCT was 42.72%(44/103). The incidences of edema-proteinuria-hypertension syndrome (EPH-syndrome), premature rupture of membranes, fetal macrosomia, operative deliveries and perinatal morbidity were higher in women with GIGT/GDM than in women without GIGT/GDM. It suggests that 50gGCT is an ideal method of screening for GDM and should be performed on all pregnant women.

TGF-β has been shown to be one of the most important regulators in chondrogenesis and osteogenesis. Daily subperiosteal injection of TGF-β, which was extracted and purified from bovine platelets, into adult mouse femur resulted in proliferation and differentiation of the mesenchymal cells, chondrogenesis, and endochondral osteogenesis. After cessation of the injection, the endochondral ossification occurred widely, resulting in replacement of the cartilage with new bone. These phenomena demonstrate that exogenous TGF-β stimulates mesenchymal proliferation and differentiation that occur in early fracture healing and suggest the possibility of clinical application of TGF-β for fracture repair and bone transplantation.

The aim of this study was to assess whether the angiotensin-converting enzyme inhibitors captopril and enalaprilat could change the tolerance of nitroglycerin in isolated rat aortae. In aortic rings precontracted with potassium chloride, captopril (1 μM) but not enalaprilat (0.1 μM) incubation potentiated the responses to nitroglycerin. It is suggested that captopril can reduce the tolerance of nitroglycerin because it is a sulfhydryl group donor.