1985年 · 第98卷第04期

Forty-five patients with enlargement of the parotid or submandibular salivary gland were studied clinically, histopathologically and histochemically. It is concluded that there is a kind of salivary gland enlargement which shows the nature of degenerative changes. Accordingly, the term "degenerative sialosis" is proposed to replace the confusable term "benign enlargement of salivary gland".

The culture of human fetal pancreas demonstrated that amylase both in culture media and pancreatic tissues were undetectable on the 5th day of culture. The average contents of insulin in culture media gradually decreased during the period from the 2nd to the 10th day. The insulin release test proved that B cells of fetal islet remained well functioning. Histologic examination showed that after short-term culture the exocrine component of fetal pancreas rapidly degenerated, necrosed and disappeared, while islet cells and ductule-like tissues kept proliferating and developing. The results of the culture of fetal pancreas demonstrated that it may be the ideal method for preparing donor islet tissue. 24 Type l diabetics were transplanted with short-term cultured islet tissues of 6-11 human fetal pancreases with gestation age of 13-34 weeks. The islet grafts were transplanted intramuscularly or intraperitoneally in 7 and 17 patients respectively. The transplantations were effective in all of the patients except one. The time interval between the transplantation and the beginning of taking effect was 18.26±10.45 days (7-52). These patients were followed up for 6-16 months. The average daily insulin requirements of 23 diabetics before transplantation were 53.61±13.28 μ (38-84 μ), and at the last follow-up examinations 21.48±9.67 μ (8-44 μ), being reduced by 58.81±16.66% (28.57-89.47%). The average fasting and postprandial plasma glucose levels were 211.87±82.31 mg/dl and 225.78±98.52 mg/dl before transplantation and were 140.87±29.85 mg/dl and 163.82±69.77 mg/dl at the last follow-up examinations. Two patients ceased insulin treatment for a period of time. The islet allografts of 23 effectively transplanted diabetics all worked well, none of them was rejected.

Fourteen patients received Z-shaped osteotomy for one-stage femoral elongation. Of these, 10 were male and 4 female with age ranging from 14 to 21 years. Twelve patients had sequelae of infantile paralysis, one congenital hip dislocation, and one coxa plana. This operation lengthened the limbs from 2.5 cm to 4.2 cm, and the average period of bone union was 6.7 months. The indications, preoperative preparations, operative procedures and bewareness, postoperative measures, as well as the advantages of the operation are discussed in detail.

We measured the electroretinographic (ERG) intensity-response function and the values of Rmax, K and n in various retinal disorders. The measurement showed many differences. Rmax values were abnormally decreased in retinitis pigmentosa. Although in cone dystrophy or macular degeneration, the Rmax was normal, and the n or K values were abnormal. Therefore, in order to increase the clinical information value of the ERG in retinal disorders, we consider it necessary to further characterize the various parameter changes in these retinal diseases.

This paper reviews the current status of treatment of hepatoceleular carcinoma (HCC). In early detection, early diagnosis, and early treatment, great progress has been achieved since 1971 by using alpha fetoprotein (AFP) screening and monitoring. With the discovery of subclinical hepatocellular carcinoma (SCHCC) and the aggressive approach to symtomatic HCC, the prognosis has improved encouragingly, with the 5-year survival rate increasing from 2.6% in the 1960s to 20.6% from 1977-1982. New concepts of the natural history and staging of HCC, policy on and approach to the treatment of SCHCC, policy on treatment of moderate stage HCC, current status of treatment of late stage HCC, and latest trends and future prospects of the treatment of HCC are discussed in the paper.

Following HB vaccine inoculation, neonates developed immune response and gave a high anti-HBs seroconversion rate (range 92-100%). The comparison of the 7.7% (1/13) HB infectivity rate in the vaccinated group with the 80% (8/10) in the placebo group showed that HB vaccine is effective in interrupting maternal HBsAg carrier transmission. Since there is neither HBsAg nor anti-HBc in vaccinated neonates born to HBsAg-negativc mothers, we consider that the HB vaccine is safe to the neonates.

Five cases are reported including three with perpetuation of functional BBB and two with alternation of BBB. In conjunction with the illustration of these ECG manifestations, the mechanism of transseptal concealed bundle branch conduction is dis cussed. As a normal phenomenon of cardiac electrophysiology, concealed bundle branch conduction may either occur in normal physiologic situations or complicate a pathologic process. Our Cases 2, 3 showed LBBB patterns at cycle lengths of 500 and 700 msec, which was much longer than the usual cycle lengths associated with intraventricular aberrancy, suggesting a pathologic prolongation of refractory period in left bundle. Case 1 maintained a complete RBBB patterns until the cycle length gradually prolonged up to 1,330 msec, indicating an abnormal recovery time in the right bundle.

Lymphocyte subpopulations (T, B, D and N cells) in both CSF and peripheral blood (PB) in 23 patients with sporadic encephalitis were studied. They were detected by E+YC mixed rosette assay and determination of immunoglobulin and complement 3. 22 patients with Japanese B encephalitis and 40 with demyelinating disease (Guillain-Barré syndrome and Devic's disease) were selected for comparison. The immunologic abnormalities in sporadic encephalitis differed significantly from those of viral encephalitis, but were similar to those of the demyelinating diseases. This, combined with the pathologic findings published, suggests that sporadic encephalitis in China may be mostly a type of allergic encephalitis with immunologic pathogenesis, better known as autoimmune encephalitis. The value of examination of the CSF lymphocyte subpopulations is discussed.

Sixty-two patients with end stage renal disease were selected for continuous ambulatory peritoneal dialysis (CAPD) from Sept 1980 to March 1983, CAPD was performed with plastic bags containing 2-liter dialysate solution. Most patients commenced with 4 bag exchanges per day, with good results. The total treatment time was 558 patient-months in 31 months. 42 patients were treated for more than 6 months and 24 for more than 12 months. The longest survival was 24 months. 22 patients died. 30 had CAPD at home for 2-16 months. The mean peritoneal clearance of urea nitrogen and creatinine was 7.5±2.8 ml/min and 13.4±5.3 ml/min, respectively. Plasma middle molecules were significantly lower after CAPD. Clinical features of heart failure and pericarditis disappeared within 1-4 weeks. The mean protein and FAA losses in the dialysate were respectively 14.4±8.0 and 2.1±0.5 g per day. The most outstanding complication was peritonitis. Gram positive organisms predominated. There was one episode of peritonitis per 8.2 patient-months. Bacterial peritonitis was early treated with prolonged peritoneal lavage and drainage without the addition of antibiotics. The possible development of ventricular arrhythmias due to hypopotassemia resulting from long-term use of potassium-free dialysate and from glucose in take through the peritoneal route is discussed.

CT scanning with pressure exerted on the patient's neck vein is of clinical significance in the diagnosis of primary orbital varices. It is simple and effective. The method may show orbital varices that cannot be detected by conventional CT scan.