1982年 · 第95卷第04期

A study was made of patients with acute myocardial infarction (AMI) admitted to a colla-borative group of 16 to 21 hospitals in Beijing, including Fuwai Hospital, in an 8 to 9 year period since 1972. The total number of admissions per year in 16 hospitals showed a steady increase, being 604 in 1972 and about doubled by 1979, with no significant change in age-composition. The hospital fatality rate declined from nearly 25% in 1972-1973 to around 12% in 1977- 1979. The fatality rate was higher in the>60 age-groups as compared with the younger patients. About one third of the patients were hospitalized within 4 hours and 70-75% within 24 hours after onset. No significant difference was found in the fatality of patients admitted at different times after onset. About 20-30% of hospital deaths occurred in the first 24 hours of illness. The major causes of death, according to data from Fuwai Hospital, were pump failure (28.8% manifested as shock in 24.5%), cardiac rupture (35.1%) and ventricular fibrillation (19.1%). Primary ventricular fibrillation became a less important cause of death in later years.

This paper presents a brief review of seasonal influences upon psoriasis in China. The incidence, onset age, types and treatment of the disease and laboratory investigations are detailed. In conclusion, the author points out that continued efforts should be made to find out the causative factors and more effective treatment. It is hoped that traditional Chinese medicine will contribute to the treatment.

Improved nitrogen sparing effect is demonstrated in this study when the infused amino acid mixture pattern contains more nonessential amino acids (NAA). Under the same investigative regime, patients in Group A received the amino acid mixture containing 23.9% NAA and those in Group B received the amino acid mixture containing 54.1% NAA. The daily intake (expressed as nitrogen) was 8 gm/M2/d (about 240 mg/kg body weight) in both Groups A and B. Nitrogen balance study showed that the average nitrogen balance was -3.01 gm (SD=2.67) in Group A and -1.12 gm (SD=2.67) in Group B. The difference is statistically significant (p<0.01). The presumed mechanism for improving nitrogen balance may be, the pattern of amino acid mixture in Group B is more "balanced" than that in Group A. But the optimal composition of NAA needs further investigation.

Intermingled transplantation of porcine and human skin is done in 63 extensively burned patients since 1972. After 3rd degree burn eschar excision, large sheets of partial thickness porcine skin are wrapped on the wound and autoskin inserted into the premade holes. During the first 2 weeks the porcine skin is kept viable, probably by body fluid osmosis and it is rejected by host granulation tissue growth 13-21 days afterwards. The main sites of rejection reaction are located around the heterodermal appendages and heteroepidermis. Only mild lymphocytic infiltration can be observed in the porcine collagen serving as a framework for the growing autoepithelium. Therefore if the spaces between autoskin grafts are small and the porcine hair follicles superficially seated, the wound can be eliminated by sandwiching similar to that of intermingled homo- and autoskin grafts. The overall mortality in this series is 25.5%. The average burned area of the survivors is 57.7±19.6%, with 35.45±15.68% 3rd degree burns.

Chronic atrophic gastritis (CAG) seen in Shanghai has its own characteristics quite different from those reported abroad. It merits our attention for further exploration of CAG etiology, pathogenesis, diagnosis and treatment, especially its relation to gastric carcinoma, a high incidence disease in Shanghai.

An analysis is made of 3 choriocarcinoma autopsies and 2 malignant hydatidiform moles. A single cerebral metastatic tumor was found in 12 and multiple metastatic tumors in 20, of which 17 were bilateral. Three cases had cerebral embolisms. The preferred sites of cerebral metastasis were the parietal and occipital lobes, especially at the junction of the parietal, occipital and temporal lobes. The pathologic features of the cerebral metasitatic choriocarcinomas showed 4 different types: Type I (tumor mass) 10; Type II (hematoma) 15; Type III (embolic) 3; Type IV (mixed) 7. There were 16 with massive hemorrhage, 6 rupturing the cerebral ventricles.

Internal iliac artery ligation is used for controlling hemorrhage during suprapubic prostatectomy in 110 cases. Of these, 2 were over 80 years old, 18 had hypertensive cardiovascular disease and 16 showed myocardial insufficiency. All withstood the operation uneventfully. No evidence of ischemia was noted in the pelvic organs. The amount of blood loss was estimated during and after operation in 34 cases, compared to other prostatectomy procedures, blood loss is minimal as is the risk of hemorrhage. Since it is not necessary to suture the vesical neck as in the Hryntschak technic, the incidence of urethral stricture can be lowered. Hence it is a suitable procedure for suprapubic prostatectomy.

Piperaquine, 1,3-bis [1-(7-chloro-4'quinolyl)-4'-piperazinyl]-propane, belonging to the 4-aminoquinolines, is a synthesized drug with a chemical structure identical with 13228 RP. In Hainan Island, Guangdong province, 43 cases of Plasmodium falciparum were treated with the drug at a total dose of l.8 gm base for each adult on 2 consecutive days. The fever and asexual blood parasites cleared up within 72 hours after administration, showing the drug to be an effective schizonticide. In order to observe the long-acting suppressive effect of the drug, field trials were carried out on a relatively large scale during the contagious seasons (from June through September) in 3 consecutive years from 1972 to 1974 in a Hainan Island county. In several villages of this county every person took 2 tablets (300 mg piperaquine base each) monthly from June through September, 1973. The malaria incidence in the treated group lowered steadily from 2.8% (in June) to 1.4% (in September), whereas that of the non-treated control group in the same village was 5.8%-10.3%. In the trial of 1974 the rate of parasite carriers was reduced from 33.8% before administration to 10.6% after the last administration. The actual period of protection afforded by the drug was about 20 days The side-effects, such as headache, listlessness and dizziness were mild. No serious toxic symptoms were noted.

The SRBC-receptor may either be situated loosely outside the T cell surface membrane, or may be a part of a protein anchoring upon or penetrating the surface membrane which can be easily removed or recombined. Isolation of the SRBC-receptor by affinity chromatography greatly short.ens the time needed for isolation from more than a week to within a working day. Both time and reagents are saved and the columns can be used repeatedly. The receptor is purified 240 times and only 1 component is obtained by us whereas Chisari, Owen and Fanger and our previous experiments all showed SRBC-receptors of 3-4 components. The SRBC-receptor is not merely a characteristic T cell marker, its role in T cell activation by SRBC is of interest for further investigation. The authors think that the study of the SRBC-receptor is of importance in cellular immunology both theoretically and practically.

35,529 cases examined fibergastroscopically are collected from 52 domestic papers for calculation of conditional and prior probability values of 4 classes of diagnostic results. According to the program, these values are taken as computer input. When a new patient is diagnosed, the output is in the form of probability values of various suspected disorders. The maximum probability value is taken as the result of computer-aided diagnosis (CAD). The CAD accuracy of 58 gastric cancer cases confirmed pathologically is 87.93% and reliability 89.47%. Total agreement rate of 132 cases in 4 classes is 81.82%. CAD is promising in differential diagnosis of gastric cancer. Statistical analysis shows. that the ac- curacy and reliability of CAD are Superior to barium gastroenterography and experienced physician diagnosis.