1984年 · 第97卷第01期

In China cancer has become the second leading cause of death in men and the third leading cause of death in women. Each year approximately 700,000 people die of cancer. Mass screenings have picked up many early cases for radical treatment with good results. However, early detection programme, though effective in certain types of cancer, needs tremendous amount of man power and money which make it impractical in a big developing country like China In the past decade or so, we have been pursuing an approach to, cancer control which focuses primarily on prevention, especially in cancer-prone areas. Clues provided by pioneering epidemiologic surveys have indicated that both environmental and host factors are playing part in the causation of cancer. A number of carcinogens have been demonstrated in the environment and some are synthesized de novo from precursor substances in the body. Although they are shown to be carcinogenic in experimental animals, it is meaningful only if they are so in men. People exposed to environmental carcinogens are not equally vulnerable. Susceptibility may be hereditary or acquired. Genetic susceptibility as revealed by family studies can be explained, in part, by defect in DNA repair and/or HLA-associated Ir gene defect. Nutritional imbalance and local precursor lesions arc among the acquired host factors modifying human resistance to environmental carcinogens. These two factors are perhaps causally related. This offers ample opportunity to carry out nutritional intervention particularly in high-risk people for the prevention of human cancer.

310 patients with portal hypertension underwent limited side-to-side portacaval shunt with splenectomy from July 1960 to June 1981. Of these, 70 had emergency shunts and 240 elective surgery. 217 (70%) had a history of massive hemorrhage of the upper gastrointestinal tract. The stomal size was chosen according to the free portal pressure (FPP) taken during operation. Operative mortality in 228 cases (12 followed up less than 6 months being excluded) was 3.9%.The 1-year survival rate was 97.5% and 3-, 5-, 10-, 15-, and over 15-year survival rates were 92.9%, 80%, 78%, 46.5% and 33.3% Esophageal varices improved in 84.4%; rebleeding rate was 11.4% and ascites disappeared in 86.7%. Postoperative encephalopathy was observed in 19.8% and seems to bear some relationship to patient age and stomal size. Oxygen saturation measurement, portal venography, and results calculated according to Gorlin's formula showed that limited side-to-side portacaval shunt partially diverts portal blood flow.

The in vitro aggregability of platelets and release of platelet granular material were studied in platelets isolated from cynomolgus monkeys (Macaca fascicularis) as related to oral medication with aspirin and dipyridamole. In treated monkeys platelet aggregation decreased in response to low but not high collagen concentrations. Release of platelet serotonin reduced in treated animals at all collagen concentrations but this reduction was more pronounced at low collagen concentrations. The effectiveness of aspirin and dipyridamole in preventing platelet aggregation and release reaction at sites of vascular injury may therefore depend on the amount of exposed subendothelial collagen.

60 cases of steroid responses to corticosteriod in high myopia are reported and compared with 67 normal subjects and 23 close relatives of primary open-angle glaucoma patients. The frequency of high and intermediate pressure responses to corticosteroid in persons with high myopia was significantly higher than in normal subjects (p<0.01), but not different from that of close relatives of patients with primary open-angle glaucoma (p>0.05). The steriod response was correlated to the initial pressure and C value (p<0.01); it may not be inherited by a single gene, but is possibly of polygenic or multifactorial hereditary nature.

Rieger's syndrome is not common in China. We encountered three familial patients who had glaucoma and abnormalities of the maxillas and teeth, 2 being blind. Glaucoma is the main cause of visual defects, so particular attention should be paid to intraocular pressure. The heredity and characteristics of the syndrome are briefly discussed.

An E-YC mixed rosette assay for detecting T, B, D and N lymphocytes in human cerebrospinal fluid (CSF) simultaneously is simple and reproducible, and it requires less CSF. The mean values of lymphocyte subpopulations in 20 cases of various nonimmune diseases of the nervous system were counted by the method. Compared with the blood values, the percentage of T-lymphocytes in CSF was higher, B- and N-lymphocytes were lower and D-lymphocytes were the same. Several explanations are suggested for these results.

This paper reports a method for experimental induction of bronchogenic carcinoma by intra-lobarbronchial instillation of carcinogenic iodized oil in rats. The animals used in the study were divided into 4 groups, each given different dosages. The 3-methylcholanthrene (MCA) or MCA and diethyinitrosamine (DEN) were dissolved in iodized oil. The results show that 49 of the 57 Group I outbred rats developed bronchogenic squamous cell carcinoma within 240 days, a tumor induction rate of 85.9%. All 25 standard Wistar rats of Group II developed the same type of carcinoma in 80 days, the tumor induction rate being 100%. The 35 standard Wistar rats of Group III developed bronchogenic carcinoma in 22 days, with a tumor induction rate of 100%. No respiratory tract tumors were found in any of the 40 control animals of Group IV. The roentgenographic results coincided with the gross pathologic examination. The advantages of this method are: the instilled carcinogen localizes in 1 or 2 lobes with little injury to lung tissue and only slight irritation to the respiratory function; because the carcinogen is injected deeply into the bronchioli respiratorii or ductuli alveolares it acts with sufficient effectiveness without any oil rejection by the animal; carcinogen instillation is required only once or twice; and the iodized oil plays a dual role as liposolvent and contrast medium, the former action dissolving the carcinogen into its more effective form and the latter being good for roentgenography. Results as observed in Group III probaly better for rapid development of lung carcinoma in Wistar rats.

The finding of calicivirus and studies of its morphology, serology and association. with gastroenteritis are reported. This virus was detected by electron microscopy in the feces of 2 infants with acute gastroenteritis. Its size averaged 31.4±1.7 nm in diameter. Morphologically, it was characterized by 7 hollows and a hexoaristate star (Star of David). Antibody titers in the convalescent phase-serum in the two cases increased to over 80 times and 160 times that in acute phase-serum. Calicivirus was proved to be the etiologic agent of the acute gastroenteritis in these 2 cases.

Expanded trials of praziquantel in schistosoma japonicum infections to assess the drug tolerance of a larger sample of patients treated largely under field conditions, of advanced schistosomiasis patients and of those having concurrently a wide variety of other diseases are reported. Altogether 716 cases were treated, among whom 47 were advanced cases with splenomegaly or schistosomal liver cirrhosis with or without ascites. 193 had concurrently diseases of various other etiologies. All the series were given the same dose regimen: 10 mg/kg tid 2 days. Tolerance was good in all, the only severe toxic side effect necessitating withdrawal of treatment was generalized urticaria. Neither clinical nor biochemical evidence of hepatotoxicity or cardiotoxicity was observed except for slight and transient posttreatment electrocardiographic changes in a few. Drug tolerance of advanced schistosomiasis cases is stressed in the light of the role played by the liver in the bio-transformation of chemotherapeutic agents.

Since May 1972, vein grafts have been used to restore circulation in electrical injuries of the upper extremity when the wrist is the center of electrical injury associated with obstructed blood supply. Saphenous vein grafts were used in 15 limbs of 14 patients where wrist electrical injuries threatened complete hand loss. Ten of the hands were free of necrosis with motion and sensibility basically recovered. The other 4 (5 limbs) failed operatively for various reasons, resulting in forearm amputation. Clinical practice shows that successful surgery depends upon whether secondary infection is effectively controlled, particularly in those who are brought to the hospital late with wound infection finger gangrene. This paper reviews the measures for controlling postoperative infections in vascular grafts to restore wrist blood flow and the clinical experience gained in the successful treatment of these patients (6 injured limbs of 6 cases), preventing amputation. We hope the method will be improved and its use broadened.