1982年 · 第95卷第12期

This case-control study was made in order to study the risk factors for coronary heart disease (CHD). Patients who survived acute stage of myocardial infarction (MI) diagnosed with certainty clinically were chosen as index cases. Controls were matched in sex and occupation, with an age difference of less than 5 years. They were free from evidence of CHD and had negative electrocardiographic exercise tests. Altogether, 200 consecutive Mi cases admitted to our hospitals were investigated. They included 179 males and 21 females. Average ages of patients and controls were 60.5 and 60.3 years. Association of hypertension with myocardial infarction is far greater than with controls. The relative risk is 5.5-7.6 depending on the hypertension diagnostic criteria. There is also a higher association between cigarette smoking and MI with relative risk at 3.6. No association is found with serum cholesterol level, body weight index, quantities of meat or rice intake, sleep, physical exercise, past history of diabetes mellitus or CHD family history. Hypertension and smoking are apparently the Ml risk factors in this part of China.

Based upon endoscopic, histopathologic and immunologic studies of 71 cases of chronic atrophic gastritis seen in Shanghai, we evaluated the chronic atrophic gastritis classification of Strickland and Mackay. From the morphologic point of view, we agree with Strickland and Mackay, dividing chronic atrophic gastritis into Type A and B. But we did not find parietal cell antibody (PCA) of help in type differentiation. For further discrimination, gastric analysis with pentagastrin and dynamic gastrin secretion stimulated by an augmented protein test meal seem to be useful guides. The latter test has enabled us to further divide Type B atrophic gastric into 2 subtypes B1 and B2.

This paper describes a microassay method of serum high density lipoprotein (HDL) cholesterol. To isolate HDL, the modified NaPT-Mg++ microtechnic was used requiring only 0.2 ml serum. The coefficient of variation was<5% and the values obtained correlate well with those obtained by Maddison et al's method. This method was suitable for routine use in the clinical chemistry laboratory. Serum HDL-cholesterol concentration was determined in 722 healthy Chinese adults, being 49.7±10.6 mg/dl in males and 53.0±12.3 mg/dl in females.

Concentric sclerosis may be a variant of disseminated sclerosis, especially the acute type. From 1928 to 1980 39 cases of this disease were reported in Western countries. In China, Lin has reported 2 cases. This paper presents a characteristic case with light and electron microscopic examination who died soon after discovery of the disease.

A 3 year-old girl with a 49,XXXXX karyotype is reported. The patients showed some stigmata similar to those of Down's syndrome such as mental retardation, epicanthal folds, etc. Chromosome examination of peripheral lymphocytes using G-banding technic reveal the 49,XXXXX karyotype (304/324). 81.4% of the buccal smear cells were X chromatin positive, of which 5.34% showed 4 X-chromatins. An X-chromatin with peculiar morphologic characteristics was found in some of the cells with 4 X-chromatins.

According to the literature, in the rare disease of tumoral calcinosis, the masses grow progressively, slowly or relatively rapidly, and finally develop into a large tumor. No case of spontaneous regression has been noted. The authors reported 2 cases, Case 1 was reexamined 6 months after first hospitalization, all the untreated masses had regressed to about half of their original size, demonstrating the possibility of self resolution. Tumoral calcinosis probably occurs fairly frequently though it is seldom recognised. With a deeper understanding of the condition, more cases will be discovered.

Of the 8 cases of pulmonary arteriovenous fistula (PAF) presented, 7 are proved surgically and 1 angiographically. They are diagnosed and treated within 20 years. X-rays of these cases show unilateral PAF in 7, 5 right and 2 left with 1 bilateral. The X-rays a.re divided into mass shadow, nodular and diffuse types with the mass shadow type most common. Tomography is useful to demonstrate the draining afferent and efferent vessels and details of the fistular mass shadow. Pulmonary angiography may give a correct diagnosis in difficult cases and show the extent of the lesions, but the contrast medium should be injected into the main pulmonary artery, exposing both lung fields to avoid overlooking lesions.

The components and structure of pigment gallstones are investigated by chemical analysis, histochemistry, infrared spectroscopy, emission and atomic absorption spectroscopy and polyacrylamide gel electrophoresis. The results show that the components dissolved in ether, hydrochloric acid, chloroform and ethanol are cholesterol, inorganic salts and bile pigment. The residues called "insoluble" components consisting of proteins, glycoproteins, polysaccharides and bilirubin polymers. This suggests that chelate type bilirubin polymer formation may make solubilization of pigment stones difficult. When the supernatant of fresh human bile collected from a T-tube is incubated in vitro, precipitate may form. In this way, the process of bilirubin precipitation in bile can be observed. The authors conclude that the increment of bile salts or glucuronic acid concentration in bile prevents bilirubin precipitation; apart from β-glucuronidase, there are other factors in the bile inducing conjugated bilirubin hydrolysis.

Spurred by recent advances in the ancient science of acupuncture in China, world interest in the subject has renewed. While the benefits of acupuncture are evident, its. mode of action and the existence of channels and collaterals are major controversial subjects. Based on personal experience and that of some of their colleagues and patients, the authors believe that channels and collaterals exist. These channels not only play a role in the treatment of deep seated dis- eases and analgesia induction and probably also moderate normal healthy perception. The existence of channels and their collaterals has not been proved anatomically.

Blood sugar and insulin were measured serially before and during slow continuous insulin infusion for 4 hours in moderate uncontrolled diabetes mellitus. Soluble insulin was added directly to the infusion containing 5T。 glucose in isotonic saline (GS group, 21 cases) and 0.9% NaCl solution (NS group, 17 cases), at 3 units/hr. Blood sugar dropped gradually within 4 hours with insulin infusion. The mean blood sugar concentration fall per hour was 45 mg% in the GS group and 47 mg% in the NS group. Plasma insulin averaged 120.9 µU/ml concentration. We recommend that iv insulin infusion be 3 units/hr to control adult diabetic ketoacidosis. There is no need to add albumin as small insulin doses are added directly to the iv infusion bottles. Meticulous clinical observation and repeated blood sugar measurements in each patient are necessary to regulate the insulin and glucose doses to avoid hypoglycemia.