1996年 · 第109卷第01期

OBJECTIVE To study the clinical and epidemiological characteristics of the first 100 reported AIDS cases in Hong Kong. PATIENTS AND METHODS The case records of the first 100 AIDS cases reported to the Department of Health were retrieved. An analysis was made on their demographic data, clinical and immunologic profile, treatment received as well as mortality. RESULTS The AIDS patients were reported over a ten-year period, from February 1985 to March 1994. The majority of them were male, Chinese and between the age of 20 and 49. More than 80% acquired HIV via sexual contact. The most common primary AIDS- defining illness was Pneumocystis carinii pneumonia (PCP), which occurred in 46 patients. Eight episodes of Penicillium marneffei infection have been recorded. Fifty-nine patients have received antiretroviral therapy whereas PCP prophylaxis was given to 47 patients. The mean CD4 count at HIV and AIDS diagnosis was 394/μl and 121/μl respectively. Sixty-seven patients were known to have died at the time of the analysis. PCP was the most common cause of death, accounting for over one-fifth of the cases. The median survival after AIDS diagnosis was less than 2 months for cases reported in 1985-1987 and over 15 months for those of 1990-1991. CONCLUSIONS Pneumocystis carinii pneumonia was the most common initial AIDS-defining disease and cause of death in Hong Kong. Survival of the patients has gradually improved over the past few years.

OBJECTIVE To study the machanism of the development of intestinal metaplasia through the transplantation of a flap of gastric wall with vascular pedicle to the intestines. METHODS The pedicled gastric wall flaps of Wistar rats were transplanted to their duodenum, jejunum and colon respectively. After the operation the rats were killed at the 3th, 6th, 9th and 12th month respectively, and histological change of the gastric grafts was observed with optical and electron microscopy. RESULTS Intestinal metaplasia was found in all the gastric grafts transplanted to the intestines and the alkaline phosphatase positive intestinal metaplasia was seen in the gastric graft mucosa transplanted to the duodenum and jejunum. CONCLUSIONS The formation of intestinal metaplasia in the gastric mucosa may be related to a change of the microenvironment around the tissues, and gastric mucosa may differentiate into intestinal mucosa by the increase of pH value. The possible mechanism of the development of intestinal metaplasia was discussed.

OBJECTIVE To investigate the combined effects of photofrin (Pf) Ⅱ and laser irradiation on mice bearing subcutaneous tumors. METHODS Ehrlish ascites tumor cells (1×107) were implanted subcutaneously into the breast area of ICR mice. The tumors, when grew up to 0.55±0.15cm3, was administered of laser irradiation (514.5nm, 112.5mW/cm2 for 11.12 min with a total energy 75J/cm2) after intraperitoneal injection of Pf Ⅱ (5, 7.5, 10 and 15mg/kg body weight) once a day for three successive days. RESULTS The mortality rate (MR120) in the tumor control was 93.7% and the mean survival time (MST120) was 46.6 days. The best therapeutic effect (50% mortality rate, 53.8% tumor control rate and mean survival time 86 days) was observed in the group treated with 7.5mg of Pf Ⅱ per kg of body weight and total irradiation energy of 75J/cm2 (112.5mW/cm2 for 11.12 min) with 514.5nm argon ion laser light. CONCLUSIONS The effect on the survival rate of tumor cells and synthetic rates of DNA, RNA and protein were obviously inhibited, as the dose of pf Ⅱ and laser irradiation increased.

OBJECTIVE Although surgery is relatively successful in eradicating local tumor, post-resection five-year survival rate for esophageal cancer is still lower than 30%. Multiple factors are found to influence the long-term results after surgical treatment. However, recent investigations have focused on the significance of lymph node matastasis (LNM), which seems to be one of the most important factors leading to poor survival. Hence, the prognostic significance of LNM in surgical resection of esophageal cancer was studied. METHODS The rate and degree of LNM were evaluated and their prognostic significance was investigated through a retrospective study of 474 patients with esophageal cancer treated by surgery alone. RESULTS LNM was positive in 211 patients, with an incidence of 44.5% (211/474). A total of 5382 lymph nodes were resected and studied pathologically, among which metastasis was found in 690 nodes with an overall LNM degree of 12.8% (690/5382). The 5-year survival rate was 30.6% (145/474) in the entire series, 12.8% (27/211) in patients with LNM, and 44.9% (118/263) in those without LNM. CONCLUSIONS Surgery remains the first choice of treatment for carcinoma of the esophagus, and that meticulous lymph node dissection is an important practice of surgical oncology. However, in more advanced cases of this disease, surgery alone is of limited value in eradicating all cancer compromized tissue, and therefore the routine practice of extensive lymph node dissection in such cases may not be rewarding.

OBJECTIVE To establish a method for localization and qualitative diagnosis of glioma. METHODS The monoclonal antibody SZ-39 against human glioma was labelled with 131I and injected intravenously into 40 patients with intracranial occupying lesions proved by X-CT. 72 hours after 131I-McAb-SZ39 administration, cranial bone nuclide-imaging agent 99mTc-MDP was injected intravenously, and the patients were examined by SPECT scan with dual nuclide double channel tomography and special software. On radio-immuno-image, the immunocomplex formed by specific conjugation of 131I-McAb-SZ39 with target tissue was red, while the cranial bone incorporated with 99mTc-MDP was green. The location of the immunocomplex area could be identified by the superimposition of the images. RESULTS 21 patients with positive targeting diagnosis of glioma showed the accuracy rate checked by SPECT was 81%(17/21) and by X-CT 48% (10/21). Seven patients with negative targeting diagnosis showed the accuracy rate checked by SPECT was 86%(6/7) and by X-CT 14% (1/7). Pathologically, the sensitivity of targeting SPECT to glioma was 94.5%(17/18) and that of X-CT 55%(10/18). CONCLUSIONS Targeting SPECT examination could be used for localization and qualitative diagnosis of glioma and make up the inadequacy of X-CT in the qualitative diagnosis of atypical incipient and recurrent glioma, meningioma, metastatic carcinoma, and inflammatory lesions of brain.

Rotaviruses are the most important etilogic agent of severe diarrhea illness of human beings. Historically, rotaviruses were identified by their electron microscopic morphology and their genetic content of 11 double-stranded RNA segments.

535 species of Arbovirus have been registered in the WHO Center of Arbovirus in the USA in 1994. But in China, for a long time, only Japanese encephalitis, Russian spring summer encephalitis, Dengue and Xijiang haemorhhage fever virus have been isolated.

Infectious diarrhea has long been a major public health problem in developing countries as well as in China. The major etiological agent diarrheagenic Escherichia coli has been defined as five major categories: enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enteroinvasive E. coli (EIEC), enterohemorrhagic E. coli (EHEC) and enteroaggregative E. coli (EAggEC). We recently isolated the sixth category diarrheagenic E. coli, named as entero-adherent-invasive-toxigenic E. coli (EAITEC).

Bacterial L-forms were discovered by Klieneberger only 60 years ago and the work in this field started in our country for not more than 35 years. It progressed slowly at first, but is much accelerated during the recent 10 years.

A report published in 1992 by the Institute of Medicine of the United States Academy of Sciences called public attention to the threat of emerging and reemerging infectious diseases to people's health.