1980年 · 第93卷第12期

Intracranial pressure (ICP) monitoring in 20 neurosurgical patients with locally made monitoring apparatus is reported. The data include continuous recording of intraventricular fluid pressure in 11, epidural pressure in 8 and subdural pressure in 1. In the 3 in which integrity of the epidural space had been spoiled by skull fracture or craniotomy, modified Vries method failed to record epidural pressure for monitoring. In another 3 in which the epidural space was intact, this modified Vries method of monitoring epidural pressure was successful, but marked damping effect prevented long term monitoring. A miniature pressure transducer is indispensable in monitoring epidural pressure. Rhythmic variation of pressure waves and paroxysmal attacks of so-called plateau wave were observed on several occasions. Furthermore, the effects of intravenous mannitol, Radix Salviae Miltiorrhiza 丹参 extract in dextran as well as releasing cerebrospinal fluid to reduce intracranial pressure were also observed and recorded. It is concluded that ICP monitoring is of utmost importance in the care of critically ill neurologic and neurosurgical patients.

This article deals with the determination of the normal values and ranges of bile flow, bile content and Oddi's sphincter tension in 33 anesthetized dogs and Yinchen dandao tang 茵陈胆道汤 (Artemisia decoction or AD) action on these biliary tract parameters. Mainly a hydrocholerectic agent, AD intravenous injection is markedly effective in facilitating bile flow and reducing bile solids content. Moreover, it has obvious relaxing action on morphine caused Oddi's sphincter spasm. The experimental results provide a preliminary experimental basis for the treatment of cholelithiasis by combined traditional Chinese and western medicine as well as elucidating the therapeutic principles of Chinese medicine. The problems of rational use of morphine in combined traditional Chinese and western medicine therapy for cholelithiasis are discussed.

A case of bilateral diaphragmatic hernia due to blunt trauma with clinical manifestations similar to those of cardiac tamponade was treated successfully by bilateral thoracotomy and laparotomy. Two types can be distinguished: l. True bilateral diaphragmatic hernia; 2. bilateral diaphragmatic hernia of pericardio-diaphragmatic type. The mechanism of nonpenetrating traumatic diaphragmatic hernia is discussed. Early diagnosis and prompt surgery are emphasized.

The pathogenesis of trachoma is discussed including the conjunctival cytology, follicular pathology and chlamydial toxin pathogenic action on human eyes. It is believed that the toxin is the main factor in producing the acute symptoms. Proliferative inflammation runs a chronic course and repeated infections induce delayed hypersensitivity. The severity of the morbid condition is related closely to host immunologic status against Chlamydia. Severe trachoma represents immunopathologic changes after repeated infections. The key to prevention and treatment of trachoma lies in energetic treatment of acute cases and exacerbated cases and control of transmission. In treating severe trachoma cases with active pannus, corticosteroids should be added to the antichlamydia drugs.

Hepatitis B virus core antigen (HBcAg) and its antibody (anti-HBc) in hepatocellular carcinoma and its surrounding tissue are detected by the immunofluorescence and immunoperoxidase methods. All specimens were obtained by biopsy, formalin-fixed and paraffin-embedded. Among the 86 cases of hepatocellular carcinoma, positive HBcAg or anti-HBc was found in sections stained by both methods in 10, of which 8 were positive in the cancer cells and 5 in the surrounding liver cell tissue. Most of the positive nuclei were HBcAg positive with a small proportion of anti-HBc positive also. In the cancer and liver cells positive reactions were mainly in the nuclei. The cytoplasm of 15 cases and nucleoli of 2 were also positive. Considering the presence of both HBcAg and HBsAg (as we previously reported) in hepatoma cells, the possibility of direct hepatitis B virus (HBV) effect was suggested.

From September 15, 1977 to April 15, 1978 450,477 persons over the age of 7 were screened for schistosomiasis and 198,950 over the age of 30 were screened for colorectal cancer. 75 cases of colorectal malignant tumor were discovered, a positive rate of 37.69/100,000 (7 were colonic cancer, 14 rectal cancer, 20 polyp with cancerous change and 34 carcinoid). 2,701 had various types of polyps and 5,242 definitive diagnostic schistosomiasis. History, physical examination and occult blood test are simple, useful methods for detecting late colorectal cancer but are of no value in preventive screening of early cases. Rectal finger examination is an important, effective method of diagnosing rectal cancer, but the positive rate is 1/10 that of rectoscopy. It can not be used for mass screening as the examiner's finger can not tolerate such constant use and the finger is too short to discover higher placed tumors. The sequence of colorectal cancerous change found in our center is normal intestinal epithelium—>tumorigenic polyp or colorectal ulcer->polyp with anaplastic change—>polyp with local cancerous change—>adenocarcinoma. Cancer is seen more frequently in villous and adenomatous polyps, these are called the precancerous stage of colorectal cancer. We found no relationship between schistosomiasis and colorectal cancer. Rectoscopy and polypectomy are important methods in reducing colorectal cancer incidence.

Efficacy of praziquantel, amoscanate, hexachloroparaxylol (HCX) and a combination of the latter 2 in 98 cases of clonorchiasis are compared in a controlled study. Each drug has certain therapeutic effect, but HCX polyethylene glycol (PEG) droplet pill is the best agent. Using the formaldehyde-ether concentration method for examining fecal eggs, the negative turn-over rate at the end of 1 month of HCX is 89.3% and the cure rate is 82.8% at the end of the third month. HCX then is still the drug of choice in clonorchiasis. Praziquantel at 20 mg/kg/day for 5 days had a 33.3% third month cure rate with an egg reduction rate of 85.2%. Amoscanate at 2 mg/kg/day for 5 days, had an 80.8% negative egg turn-over rate at the end of 1 month, but this dropped to 38.5% at the end of the third month. It is suggested that this drug can only inhibit fluke egg laying temporarily. When amoscanate at 1 mg/kg/day for 4 days is combined with HCX at 50 mg/kg/day for 4 days, the negative turn-over rate is 95.5% at the end of 1 month and the cure rate is 90.5% at the end of the third month. Side reactions, however, are severer than with HCX alone and transient toxic psychosis developed in 2 cases and ECG T wave changes in 1.

Experimental study of the soluble protein fractions of Nector americanus, Ancylostoma duodenale and A. caninum by disc electrophoresis using polyacrylamide gel was performed in adult worms obtained from 19 puppies infected artificially. In comparison with the total 124 gel columns, all results such as number of bands, densitometric tracings and even the site of peaks are obviously related to the differences in the proteins. With respect to biochemical differences between species, this procedure is readily reproducible and highly sensitive and may help identify hookworm species differences by differentiating their protein fractions.

The surface of the egg shell of Schistosoma japonicum appears quite rough by scanning electron microscope (SEM) and extremely complicated in structure by transmission electron microscope (TEM). The shell is composed of a thin, very dense and apparently continuous inner layer and a thick and moderately dense outer layer. The outer surface of the egg shell is covered with numerous bristle-like microspicules, averaging 0.06 μ long and 0.02 μ in diameter at the base. There are about 600 microspicules on 1 square micron egg shell surface. Some spaced microspicule-like projection may also be found, averaging about 0.18×0.06 μ. The tops of these projections break and drop off.