1983年 · 第96卷第02期

Pathologic anatomy of 56 cases of pancreatitis is reported. 49 (94.2%) of 52 pathologically analysed cases are hemorrhagic type. The characteristic changes of acute hemorrhagic pancreatitis are severe and extensive pancreatic cytolytic necrosis followed by hemorrhage and fatty necrolsis of varying degrees. The inflammatory process may extend to the peripancreatic organs such as the mesentery, peritoneal cavity and perinephric fa.tty tissue. The moist striking changes outside the pancreas are acute pulmonary edema, acute cardiac muscle fragmentation and congestion and petechial hemorrhage of various organs, particularly the lungs, heart, duodenum and suprarenal gland. Stress duodenal ulcers also occur sometimes. The cause of pancreatic shock and pathogenesis are discussed.

A line of cultured mouse glioblastoma cells has been established. It is highly malignant with low differentiation and divides vigorously. Tumor tissue hemorrhages and necroses, cerebral tumor cell infiltration is prominent. Transmission electronmicroscope shows morphologic irregllIarity, expanded rough endoplasmic reticulum and free plasma polyribosomes. The large nuclei are irregular, have membrane pores and much euchromatin. Hyperfunctioning nucleic acid metabolism is evidenced. Scanning electronmicroscope shows cell surface microvilli, filopodia and foot processes. Intercellular adhesive devices are connected by filopodia. Tumor cell surface ultrastructure is destroyed in the necrotic areas.

Plasma factor VIII related antigen (VIIIR:Ag) is determined in 54 cases of various kinds of primary glomerular diseases and compared with the plasma fibrinogen, fibrin(ogen) degradation products and some renal function tests. The results show that VIIIR:Ag is elevated in nephrotic syndrome (Group 1), chronic glomerulonephritis (Group 2) and chronic renal failure (Group 3), especially in Groups 1 and 3. In addition, the VIIIR:Ag level has evident positive correlation with the 24-hour urine protein in Group 1 and with blood urea nitrogen in Group 3. It is demonstrated that the VIIIR:Ag level can not only be regarded as an inWortant objective index of the hypercoagulation state in renal diseases, but also reflects to some extent the severity of glomerular damage. Continuous observations of its change are instrumental in assessing the effectiveneSs of therapy and prognosis. It deserves further research.

This is a report of 350 cases of trophoblastic tumors treated with 5-Fluorouracil (5 FU) from 1965 to 1975. Large dosage 5FU (25-30 mg/kg) single agent, given in slow infusions over 6-8 hours proves to be at least as effective as, if not more so than the other chemotherapeutic agents currently used in gestational trophoblastic disease. Complete remission is obtained in 84.9% of malignant moles and 59.3% of choriocarcinomas with 5FU as a primary therapeutic agent. Patients with satisfactory immediate 5FU response also have good long-term results. Death from recurrences occurred in only 2.8%. Toxic reactions such as depression of hemopoietic function, hepatic toxicity, stomatitis, etc are milder than with MTX, 6MP or KSM. Only gastrointestinal tract reactions are more frequent and occasional pseudomembranous colitis occurs when the diarrhea is treated improperly. Two deaths occur due to 5FU toxicity, a 0.57% toxic mortality.

Four cases of multiple atrial parasystole with 2-3 atrial ecitopic pacemakers are presented with the ECGs. Three are ischemic heart disease with complete AV block, recognized as supranodal in nature according to James' criteria. The remaining case is acute inferior wall myocardial infarction with paroxysmal auricular fibrillation. Careful observation of the ECGs show 3 varieties of A waves, A1 wave of right atrial type, A2 wave of left atrial type as well as retrograde A3 wave of coronary sinus type. Double parasystoles, atrial fusion beats and exit block are also shown. Detailed measurements show the rate of each ectopic pacemaker and mutual interference of the sinus pacemaker and ectoipic pacemaker forming reversed coupling. These findings further support James' hypothesis on the intra-atrial conduction system.

This is the first report on a mermithid nematode pathogenic to Anopheles gigas baileyi in Tibet, China as far as we know, this is also the first time that An gigas baileyi has been incriminated as a host for the mermithid nematode. The nematode infection and infected larvae mortality rates are as high as 94.9% and 88.5% respectively.

Intrauterine contraceptive device (IUD) insertion at cesarean section was performed on 150 cases in this hospital from April 1981 to April 1982. A new suture fixation method is used and described. The expulsion rate is 0.7% (1 case) in 150 cases 42 days after insertion and 3.1% (4 cases) in 130 cases during the 3rd month with a 2.3% pregnancy rate. These expulsion rates are encouraging.

A method for the simultaneous determination of matrine and oxymatrine in the same biologic material and the metabolic fate of the latter are described. There is wide variation between the distribution and excretion of oxymatrine administered to rats by different routes. After IM oxymatrine injection, the parent drug concentration is high in the tissues, bile and urine However, when oxymatrine is given orally, matrine concentration is higher than that of oxymatrine. This indicates that oxymatrine may be converted to matrine in the GI tract. After absorption, matrine is distributed to the tissues and excreted in the urine. After IV injection, oxymatrine rapidly disappears from plasma It can be suited to a 2-compartment open modeL Experimental results show that matrine is probably the pharmacologically active substance in the treatment of asthma.

A case of Legionnaires' disease is reported with a brief discussion of the clinical manifestations and treatment.

The 30 years' experience in studies of microflora disturbances and their attempted adjustments was summed up. In order to observe the antagonistic action of the indigenous bacteria against the invading pathogens, a series of in vitro tests are made. In vivo studies are carried out in house rats for demonstrating ecologic manifestations of normal bacterial flora. Clinical studies are undertaken in dysentery and diarrheas. The results obtained are tabulated and described. Flora disturbances are corrected by adjustment of nutrition, disturbed micro-flora etc. The authors conclude that being aware of the existence of intestinal flora disturbance is very important to make proper diagnosis as well as to prescribe proper treatment and prevention in accordance with the microbial flora changes as the guiding principle.