1984年 · 第97卷第06期

18 cases of colonic diverticula, seen in the past 60 years in our hospital, have been reviewed. The incidence of colonic diverticulosis in this series, as judged from the necropsy cases and colonoscopy cases, was 0.12% and 0.33%-1.2%, respectively. Among colonic diverticula, right-sided diverticula were found to be 61.1%, which was 3.7 times the percentage of left-sided diverticula. Reason for this low incidence is not quite clear, but the higher crude fiber intake in the Chinese diet may be a probable explanation.

Atherosclerotic aneurysm of the abdominal aorta, which usually occurs in patients at the age of 60-80 years, is dangerous because of its tendency to rupture. Our patient, aged 19, underwent aneurysmectomy for a progressively enlarged aneurysm. The operation was done without arterial reconstruction, as the collateral circulation was adequate. Pathologic examination showed that the aneurysm was atherosclerotic in nature.

This article reports studies of the viral etiology of an outbreak of summer infant gastroenteritis in Beijing in 1982, Polyvalent antibody-immune electron microscopy (PAb-IEM) showed several kinds of virus particles in fecal samples in 72% of 50 cases. In 56%, 1 kind of virus particle was detected, i.e., rotavirus 26%, calicivirus 2%, small round virus 24%, coronavirus-like 2%. In 16%, 2 kinds of virus particles were found concomitantly. The rotavirus coincidence rate was 92% by PAb-IEM and by enzyme-linked immunosorbent assay. 38% of 42 cases with paired sera showed a 4-fold or greater rise in the titer of complement-fixing antibody to rotavirus. The PAb-IEM results agreed with those obtained by complement fixation. This indicates that rota-virus is the etiologic agent in these cases. In the patient with calicivirus particles in the stool, the titer of anti-calicivirus antibody was increased over 160 fold in paired sera, showing that calicivirus is probably the etiologic agent. In 117 fecal samples, several kinds of entero-pathogenic bacteria were isolated in only 8.5%. This shows that bacteria are not an important etiologic agent in this epidemic of summer infant gastroenteritis in Beijing.

363 diabetics in Beijing and Tianjin and 602 non-diabetics served as control were tested for the serum lipids and lipoproteins, including total serum cholesterol, triglyceride, HDL-cholesterol (HDL-C), ratio of HDLrC to LDL-cholesterol (LDL-C). The occurrence rate of hyperlipoproteinaemia in the diabetic group (21.7%) was significantly higher than that in the control group (8.3%, p<0.01). The HDL-cholestrol level and the ratio of HDL-C to LDL-C were significantly higher in diabetics with insulin treatment (HDL-C 71.62±2.88, HDL-C/LDL-C 0.73±0.048) than that in non-diabetics (HDL-C 56.95±1.44, HDL-C/LDL-C 0.60±0.03), and were lower in diabetics with treatment of diet alone and oral hypoglycemic drugs (HDL-C 56.74±1.04, HDL-C/LDL-C 0.55±0.02) than that in non-diabetics. The ratio of HDL-C to LDL-C was significantly lower in diabetics with abnormal ECG (0.51±0.04) than that in diabetics with normal ECG(0.61±0.02, p<0.05). It showed this ratio is more important than serum cholesterol and triglyceride. Several factors, such as sex, age, weight and method of treatment, can influence the serum lipids of diabetics. In order to raise the ratio of HDL-C to LDL-C, it is necessary for the obese diabetics to reduce weight. After the patient's weight becomes normal if the hyperglycemia can not be controlled by diet and oral hypoglycemic drugs, insulin therapy should be used.

By combined immunologic, histochemical and other approaches, we studied the macrophage content in 20 giant cell tumors of bone (GCT) as compared with that in 26 benign and malignant lesions of osseous and soft tissues. We found that many macrophages existed in GCT. In the cell suspensions prepared by enzymatic disaggregation, the percentage of macrophage was apparently higher than in control lesions. After serial passage, macrophages and multinucleated giant cells (MGC) gradually decreased in number, whereas spindle-shaped cells, which were negative for Fe, C3 receptor and nonspecific esterase (NSE), maintained their growth. Keeping the cuture media unchanged for 7 to 31 days, cells containing 2 to 8 nuclei could be found in primary culture of macrophages isolated from GCT. Although Fe, C3 receptors and phagocytosis were not demonstrated in almost all MGC, some of them showed NSE activity and weak resistance to trypsin. It is worth noting that a few bi-, tri- and tetra-nucleated cells formed EA rosettes and phagocytosed EA. The place of macrophages in GCT, their inter-relationship, and MGC are discussed.

Analysis of the pathoanatomical characteristics of late cases of thoracolumbar fracture-dislocation complicated by paraplegia indicates that the bony compressing structure over the anterior aspect of the vertebral canal is the main obstacle to continual recovery. We divised a new ,technique, subtotal cricumferential decompression, by which the lateral, posterior and anterior aspects of the vertebral canal can be approached, and a complete decompression can be accomplished in one stage. We treated 86 patients in this way. Of these, 64 were followed up for 2 years or more including 55 with incomplete paraplegia. The effective rate was 86%. No effect was observed in 7 patients with complete paraplegia caused by transection of the spinal cord. With wide range decompression, injury was minimal, disturbance to the stability of the vertebral column was least, and the operative results were good.

Serial duplication without concurrent aberration in other chromosomes is extremely rare in human chromosomal pathology. Such a case is reported in this paper. The propositus, a 7-year-old boy with mental retardation, cranio-facial asymmetry and minor dysmorphism, is found to have a partial serial duplication of the short arm of chromosome 3. Using high-resolution chromosome banding, the karyotype is ascertained as 46,XY, dir dup (3) (pter p2.5::p25→p21.3::p25→qter). His parents are phenotypically and karyotypically normal. The origin of such pure duplication and its significance in studies of clinico-karyotypical correlation and human gene mapping are discussed.

Chronic lymphocytic thyroiditis and lymphocyte infiltration were studied in 2,053 cases of endemic goiter. Only 7 cases of chronic lymphocytic thyroiditis and 3 of focal thyroiditis showed diffused enlargement of thyroid. Among 2,053 cases, 150 had thyroiditis (7.3%), of whom 137 (7.1%) were accompanied by nodular goiters. If focal thyroiditis was excluded, the incidence rate of chronic lymphocytic thyroiditis would be 2.39%. The increased incidence of Hashimoto's disease was considered to he due to the decreased incidence of endemic goiter and the neglect of chronic lymphocytic thyroiditis accompanied by nodular goiters. Thyroiditis occurs in the surrounding tissues of the nodule, and it is why the changes in thyroiditis were overlooked in excised nodules.

A case of primary ovarian pregnancy with intrauterine device (IUD) in situ is presented. It is of particular interest that this pregnancy terminated very early; at the 15th day of the menstrual cycle. Wedge resection of the ovary aids in differentiating between ovarian pregnancy and rupture of corpus luteum. Because the IUD is widely used in this country, it is important to be alert for this entity.

Medical education in China has a long history. This paper describes its development according to three distinct periods: the ancient period, the modern period and the contemporay period.