1983年 · 第96卷第10期

This paper presents 205 cases of retinal vein occlusion (RVO) treated according to 3 regimens and followed up periodically during the past 14 years. The clinical findings are analyzed. The effective rate of combined treatment with traditional Chinese medicine (TCM) and western medicine in retinal branch vein occlusion (RBVO) is 85.18%. 31.76% of the patients with central retinal vein occlusion and 53.04% of those with RBVO attain a visual acuity of 20/40 or better. It is suggested that TCM combined with western medicine may attain better result in the medical treatment of RVO.

41 patients (43 eyes) with compressive eye injuries caused by earthquake are treated. External ocular signs are similar in all cases and subside within a short time, but the fundus changes vary widely and are divided into 3 types according to ophthalmoscopic appearance. 7 eyes with Type 1 changes are reminiscent of sphenoidal syndrome. 9 eyes with Type 2 changes show nothing peculiar except severe optic nerve atrophy, probably a complication of maxillofacial bone fracture. 27 eyes with Type 3 changes disclose an entirely different picture, especially those with severer changes, The fundus has a milky white optic disc, thread-like arterioles and venules, and wide-spread retinal and choroid atrophic degeneration. These changes are permanent. Therapy to date remains inadequate and the mechanism underlying these changes is still unknown. Since there is no similar description of this kind of fundus change in the literature, we tentatively call it compression orbitoapex syndrome.

Fiberoptic bronchoscopy (FOB) was performed in 1,450 Chinese patients from 1978 to 1982. Diagnostic tissue was obtained in 76.07%。(372/489) bronchial biopsies and 66.18% (319/482) transbronchial lung biopsies (TBB). The three commonest tissue diagnoses were broinchial carcinoma (56.44), acute bronchitis/pneumonia (20.95%) and tuberculosis (1l.41%). Bronchial cancer is the commonest lethal malignant disease in both men and women in Hong Kong. Sarcoidosis, cryptogenic fibrosing alveolitis and extrinsic allergic alveolitis are rare in Chinese. FOB gave a diagnosis of 93.53% foir bronchosciopically visible tumour and 87.65% for nonvisible tumour. FOB also provided the diagnosis in 117 patients with sputum smear negative pulmonary tuberculosis, 21 of 24 (87.5%) immunosuppressed patients with diffuse pulmonary infiltrates, and 39 of 168 (23.2%) patients with hemoptysis and normal chest radiographs. Bronchoscopic aspirate and brush examinations were useful techniques providing the exclusive diagnosis in 12% of bronchoscopically visible tumour and 23% of nonvisible tumour. 36% of sputum smear-negative tuberculosis and 3 thrombocytopenic, immunocompromised subjects.

Open-heart surgery with extracorporeal circulation usually requires transfusion of a large volume of donor blood. This increases the risk of infectious transfusive diseases and the medical fees. From October 1977 to December 1980 we explored a way of extracorporeal circulation without donor blood in 100 cases.

Total colectomy with ileorectal anastomosis is performed for multiple polyposis in the colon and rectum. The remaining polyps in the rectum are treated with ascorbic acid, 1 gm tid; modified Bacon's operation with local polypectomy by colonoscopy for multiple polyposis in the lower sigmoid colon and rectum with some polyps in the colon; polypectomy is done, one by one in those with Peutz-Jeghers syndrome by palpation during operation.

The discovery of immunohistochemical assay has provided a theoretical basis for the treatment of breast cancer and improved the treatment.

It has been shown by many investigators that hematoporphyrin derivative (HpD) when infused intravenously is perferentially retained by malignant cells. Clinical trials both for the detection and treatment of malignant tumors have been carried out. If localized HpD is activated by visible light, particularly 625-630 nm in the wave length of the spectrum red region cytotoxic singlet oxygen is elicited. Since 1981 a study group on HpD-photoradiation therapy (HpD-PRT) has been set up in the Cancer Institute, Chinese Academy of Medical Sciences (CAMS), Beijing. PRT technic and procedure used in this group are essentially the same as first described by Dougherty and his associates, except that all the medical facilities including the HpD and laser system used are China made. 47 patients with cancers treated by PRT are presented with promising short-term results.

84 specimens are obtained from patients with gastric carcinoma and tested for ABO(H) blood group antigens. The results show that these antigens are partially or completely lost in about 75% of the specimens. ABO(H) blood group antigens are 1 of the 2 major cellular histocompatibility antigens involved in transplantation immunobiology, histoincompatibility causing transplant rejection. The authors consider that during cellular anaplasia, cells lose or undifferentiate histocompatibility antigens of ABO erythrocyte system, this may be a carcinoma cell biologic characteristic and cancer cell metastasis may be related to undifferentiation of cellular histocompatibility antigen, a new view on the mechanism of carcinoma metastasis.

Since the majority of glucagonomas are malignant, early diagnosis and prompt surgical excision are imperative. Clinicians should be alerted to the cardinal symptoms of this rare disease.

Extensive skin and soft tissue defect accompanied by damage and/or absence of blood vessels in the local and adjacent regions is a formidable problem which often cannot be effectively solved by conventional means as skin tube transfer, crossed skin flap or free skin grafting. An original operative procedure designed by our group and applied successfully to repair a massive left leg defect with extensive scarring measuring 30×12.5 cm and extending deep into the periosteum is presented in this paper. The left anterior tibial vessels and great saphenous vein were also badly damaged. A free latissimus dorsi skin flap is excised and transplanted onto the defect, while the right leg is flexed so the ankle crosses over and lies just behind the upper end of the left leg forming a 60° angle between the 2 legs. A pedicle skin flap is mobilized from the right ankle region and sutured to the left leg wound margin to form the "floor" of the skin bridge. The right anterior tibial artery and its continuation, the dorsal pedal artery, the continuation of the great saphenous vein, and the dorsal pedal vein were mobilized and severed. They are anastomosed end-to-end respectively with the thoracodorsal artery and vein of the free latissimus dorsi skin flape. Finally, the free latissimus dorsi skin flap is sutured to the right ankle skin incision edge to form the "surface" of the skin bridge. The vascular pedicle of the free latissimus dorsi skin flap is made to span the crossed legs, serving as a skin bridge through which flows the temporary blood supply to the free skin flap. After vascular training to promote new circulation formation, the skin bridge is severed 6 weeks postoperatively. The free skin flap survives The success of this procedure makes possible the plastic reconstructive repair in patients with large area skin and compound tissue defects, broadening the range of reconstructive surgery and the operative indications for large area skin and compound tissue loss.