1984年 · 第97卷第10期

A prospective epidemiologic study of gynecologic malignancy was conducted in Jiangsu Province from 1979 to 1981. The 3,901 cases included 2,640 cervical, 442 ovarian, 382 trophoblastic, 284 endometrial, 63 vulval, 60 vaginal, 20 tubal, and 10 miscellaneous cancers. In comparison with findings reported from Nanjing in 1964, the average age at diagnosis of cervical cancer was higher, the age difference between in situ and invasive cases was less, and the ratio of endometrial cancer to cervical cancer cases was increased. Endometrial cancer seemed to be correlated with early marriage. Sixty-five percent of the ovarian cancer patients were below 50 years old and thus it is doubtful that prophylactic oophorectomy could be of much value in preventing ovarian cancer. A high percentage of patients with destructive mole and choriocarcinoma had previous histories of hydatidiform mole. The ratio of chorio-carcinomas to births was higher than in the 1964 Nanjing series. However, it was very similar to that reported from the United States.

After guinea pigs were sensitized with human liver specific lipoprotein (HLSP) for a prolonged duration, collagen formation by hepatocytes in situ was observed. Possibly, the work reported here provides for the first time direct morphologic evidence that hepatocytes participate in collagen formation in the liver. Our experiment also showed that immune reactions induced by HLSP can stimulate liver cell to produce collagen. These findings may be of great significance iii the interpretation of the pathogenesis of liver fibrosis and liver cirrhosis.

Observations of 36 cases (40 legs) with incompetent deep veins as late sequela of leg thrombosis produce a set of regular pathologic changes. Re lated mainly to the duration of the clinical course, these changes form the basis of a new 3 stage classification of postthrombotic patients. The first is the completely obstructed type (Type I). The second is the partially recanalized type (Type II) which can be subdivided into 2 groups, the largely obstructed type (Type IIA) and the largely recanalized type (Type IIB). The third is the completely recanalized type (Type III). The aim of the classification is to offer new guides to choosing suitable treatment. We suggest that in Types I and IIA non-operative management be used to accelerate or wait for recanalization, but in Types IIB and III bypass or reconstructive surgery should be considered after the pathoanatomical status and clinical features are carefully studied. Stripping of superficial veins with ligation of communicating branches remains a good operation for any patient who has chronic re current venous ulcer and is not a candidate for re constructive surgery.

This article rounds up research in and treatment of fracture healing, bone tumor, spinal diseases, artificial joints and foot surgery since 1979. Ultrastructural study of experimental fracture healing has been studied extensively using both transmission electron microscope and scanning electron microscope. Clinical use of direct electric current stimulation, pulsating electromagnetic fields and osteogenic stimulating factor (a metabolic product of staphylococcus) yields encouraging results in fractures; Nation-wide bone tumor registration has just been started. Femoral head prosthesis and total hip joint replacement are used with good results in many provinces.

Lymph nodes specimens obtained by extensive resection from 181 patients with gastric carcinoma were studied. The overall rate of lymphatic metastasis was 69% and the involving rate of lymph nodes collected was 27.7%. It was found that the extent of lymphatic metastasis was closely related to the site, size and mural depth of invasion of the primary tumor but not to its histologic type evidently. A general scheme for resection and lymph node extripation in different categories of gastric carcinoma is suggested.

The causes of acute pancreatitis in 596 patients were classified as follows: dietary surfeit (40.6%), biliary lithiasis and ascariasis (21.7%), alcoholism (2.7%), pregnancy (2.6%), miscellaneous (2.6%), unknown (5.7%) and idiopathic (24.1%). The course of the disease was mild and uneventful in 81.2% of the patients, 4.5% had fulminating necrotizing pancreatitis requiring surgical treatment. The overall hospital mortality was 2.9%, and 80.8% of the survivors were followed up for more than 10 years, with a risk of relapse of 22.7%. Ingestion of large cold rice meal particularly after prolonged fasting in weak individuals was closely associated with the onset of disease. The relapse could be avoided by appropriate dietary measures.

Clinically, it is commonly seen that certain acupuncture points appear invariably tender. This tenderness is perceived either spontaneously by the patients suffering from pain or passively as revealed through simple mechanical stimulation of the diseased body. However, certain points do not have tenderness even though adequate amount of mechanical force is applied on the points. Such phenomenon suggests that acupuncture points have different functional phases depending on the state of the body health. When the body is healthy, acupuncture points are inactive or remain latent. Under a diseased state, they become either active with perceived tenderness or passive with tenderness only when adequate mechanical pressure is applied. Thus, we can characterize acupuncture points in three functional phases: latent, passive and active.

We successfully treated 4 patients with high voltage electric burn by early debridement without excising the necrosed skull bone in combination with primary flap graft or free greater omentum plus free skin graft to cover the wound. The patients had deep extensive burn of the skull, in addition to severe injury to limbs and nerves. The smallest area of skull necrosis was 4×5 cm, and the largest 15×7 cm. Early debridement removed a small amount of superficial bone tissue, and the necrosed bone plate at the inner layer was preserved. All the patients had primary healing in the short course of treatment.

A total of 1,069 autopsy cases, including 500 of hepatocellular carcinoma (HCC), 334 of liver cirrhosis (LC), and 235 of other conditions (controls) were selected from 28,342 autopsies in different areas of China and investigated retrospectively. Orcein stain was the main method for demonstrating intra-cellular hepatitis B surface antigen (HBsAg) in order to study the relationship between HCC, LC, and hepatitis B virus (HBV) infection. Of the HCC cases, 84.6% were associated with LC; 55.9% of the LC cases had HCC. The frequency of HCC in macronodular cirrhosis was 73.8%, strongly indicating the close relationship between the two conditions. The positive rates of IABsAg were 80.2% in HCC, 67.7% in LC, and 4.7% in controls. These suggest that HbsAg was closely related to HCC with background of chronic liver diseases, and liver cell dysplasia was frequently present in HBsAg positive cases. HBV infection leading to liver cell damage and proliferation especially dysplasia may be the pathologic basis of HCC development. HBV is considered an important etiologic factor of HCC.

Through a series of successive scanning electron microscopy observations (1981-1983) on adult Brugia malayi of some districts of Henan and Guizhou provinces, it is seen that on the oral rim there are 6 papillae in the inner circle and 4 in the outen 11 peri-anal papillae and 4-6 others scattered in the interspace from the postanal part to the caudal end are also visible. These observations correspond with Buckley's, but differ from those described by Chen Zi-da and Li Fei-bai. This demonstrates that the morphology of Brugia malayi in some districts is the same as that reported in other countries, therefore they belong to the same species. However, we have also occasionally seen some different features in filarial worms in some districts of Henan Province. Some adult males have 3-5 pairs of lateral papillae beyond the anal opening and some female adults have a single papilla at the sub caudal ends, seeming to show that Brugia malayi in China's vast territory and highly complicated terrain, may well differ in geographical strain or sub-species. This paper also for the first time gives more detailed descriptions of dermal circular striations of Brugia malayi, male bar-like bodies, tubercles on the lateral margin, Henan third stage larvae, papillae at the cephad end of microfilaria, cord-like matter in front of and behind the anal opening and morphology of cephad cap.