1985年 · 第98卷第09期

A double blind randomized placebo-controlled trial was undertaken to determine if hepatitis B virus (HBV) vaccine alone can prevent perinatally-acquired HBV carriage. The vaccine (16μg per dose, plasma derived, produced by the National Institute of Allergy and Infectious Disease, USA) was given to babies born to HBV carrier mothers within 24 hours of birth and repeated at one month and six months. The preliminary results of 84 infants (40 vaccine recipients and 44 placebo recipients) followed for six months indicated that this vaccine was highly efficacious. One of the 40 vaccine recipients and 13 of the 44 placebo recipients were HBsAg positive at six months of age (p=0.0007, protective efficacy 91.5%). For infants born to HBeAg positive mothers, one of 17 vaccine recipients and 12 of 19 placebo recipients were HBsAg positive at 6 months of age (p=0.0004, protective efficacy 90.7%). These results showed that HBV vaccine alone successfully prevented perinatally-acquired HBV carriage. If further studies confirm these findings, and safe, effective and inexpensive vaccines are available, HBV control is feasible.

264 high risk pregnancy patients were studied by B mode ultrasound for placental grading and biparietal diameter (BPD) measurement. The Lecithin-sphingomyelin (L/S) ratio, phosphatidyl-glycerol (PG) and foam test were performed with 81 cases as control. Repeat cesarean sections were performed in 44 patients who did not have amniocentesis and their operation timing was based only upon placental grading, biparietal measurement and clinical examination. No respiratory distress syndrome (RDS) occurred in this group after delivery. This study shows that when BPD of >8.7 cm is combined with I, II, or III placental grading neonatal Dubowitz scores correspond to 38 weeks; neonatal birth weight is greater than 2,500 g and there is no RDS. Combined BPD of ≥8.5 cm with a Grade III placenta preclude the necessity for amniocentesis to prove fetal lung maturity. Grade III placenta is more common in postdatism, chronic hypertension and preeclampsia and less common in diabetics.

The computed tomography (CT) findings in 270 patients with ovarian carcinoma are reported. The result of the study suggests that CT scanning is an effective, non-invasive procedure in demonstrating the extent of the lesions. Various CT features are presented and its main role in ovarian carcinoma are discussed.

Nd-YAG laser exposure via percutaneous-trans hepatic cholangioscopy (PTCS) has been used successfully in destruction of bilirubin stones in three patients with huge commen bile duct (CBD) stones or intrahepatic stones, which couldn't be removed by endoscopic sphincteropapillotomy (EST). Experimental studies were conducted to observe the changes in temperature of stone surface and the surroundings in air or water, during laser exposure. In addition, the correlation between the elevation and recovery of temperature of the surrounding water and the speed of water infusion was observed. A plastic tube of 6 mm in diameter was used as a model. The peak temperature of stone surface 5 mm close to the contact point of the quartz fiber at point A, B and C was 51 C, 30 C, and 158 C respectively. No changes in temperature were observed at the three points when a similar experiment on the bilirubin stone was done but in a beaker with 400 ml water. The relationship between the peak of temperature and the speed of water infusion was not significant, but the time needed for lowering a peak temperature to the original, after laser beam was delivered, was obviously related to the speed of water infusion. It should be emphasized that during the treatment of the biliary stone by Nd-YAG laser via PTCS, the water infusion at any time should be continued and it is better to keep the speed of water infusion not less than 40 ml/min. Of course, the free tip of the quartz fiber should be well contacted with the surface of the stone, so as to avoid a direct burn injury to the wall of the bile duct by laser beam.

Cystectomy specimens from 50 cases of bladder cancer were studied after en bloc fixation and processing. Specimens from 35 cases were prepared in giant histologic sections. Bladder cancer was classified into five gross types as villopapillary, lobule-nodular, flat, superficial-infiltrating and infiltrating, and six histologic types as carcinoma in situ, transitional-cell carcinoma, squamous ceU carcinoma, adenocarcinoma, undifferentiatcd carcinoma and mixed-cell carcinoma. Systematic studies showed that there was the presence of a large number of mixed-cell carcinoma, which should be classified as a separated histologic type of bladder cancer. The prognosis of this carcinoma, especially those mixed with adenocarcinoma components, was more unfavorable than that of transitional-cell carcinoma. The mixed-cell carcinoma with gross appearance of lobule-nodular type carcinoma and characteristics of inverted papillary carcinoma had a more favorable prognosis than those with gross appearance of superficial-infiltrating or infiltrating type carcinoma. Histogenesis of mixed-cell carcinoma and the recurrence of bladder cancer are discussed.

In the determination of the status of estrogen receptor (ER) of breast cancer, cytochemical (with 17-FE, ligand) and biochemical methods were used. The former was used to designate positivity, and the latter provided a quantitative value for ER (fmol/mg). Both could interpret the status of ER within a same tumor. To express the quantitative value with cytochemical method, breast tumors from 41 patients and 7 C3H mice were used and the data on ER status were detected with the two methods. Through statistical analysis and mathematic modeling, the relative weight (θ) of each positive type of cells and coefficients were obtained. The relative weights of Types A, B and C (θ1, θ2 and θ3) were 4.4, 2.8 and l.8 respectively in human tumors, and 1.9, 0.3 and 1.3 respectively in mice tumors. Thus, biochemical method could also yield the same quantitative value obtained by cytochemical method (fmol/mg). The inadequacy of both methods were suggested. About half amount of the ER was undetected only by detecting cytosol of tumor with dextran-coated charcoal (DCC) method. The status of ER may be detected morphologically and quantitatively by cytochemical method (17-FE).

Mouse L6565 leukemia is a viral lymphocytic leukemia, its strain was established in 1965 in China. The isolation of mouse L6565 leukemia virus with gel chromatography was described in this paper. The virus isolated from L6565 showed to be type C-like particle under electron microscope and was identified by simultaneous detection of reverse transcriptase activity and high molecular weight RNA determination. It was shown that the endogenous reverse transcriptase activity in mouse L6565 virus was senstive to RNase and resistant to the inhibition of actinomycin D; divalent cation was required for the endogenous reverse transcriptase activity, Mn++ being more effective than Mg++. The virus was confirmed to be leukemogenic by inoculation of virion into newborn mice of Kun Ming strain. Experiments indicated that mouse L6565 leukemia virus can be classified as a biologically active oncornavirus.

Malayan filariasis is mainly found in the north western part of Fujian province, whereas bancroftian filariasis is found in the central and southern part of this province. There were approximately 2,000,000 patients with filariasis in this province in 1958. The prevalence rate was higher in male (9.4%) than in female (7.7%). Fever attacks and elephantiasis of limbs were common in the malayan filariasis endemic areas, but less common in the bancroftian filariasis endemic areas. Analysis of hydrocele fluid showed that hydrocele was not caused by exudative reaction from the stimulation of the living worms, but was caused by inflammatory obstruction of lymphatic vessles. The periodicity indices obtained from both species of filaria in the endemic areas were over 92%. Investigation showed that C. fatigans is the chief vector of W. bancrofti while An. lesteri anthropophagus is the true vector of B. malayi. Diethylcarbamazine citrate (Hetrazan) had been used for the treatment of malayan and bancroftian filariasis with good results. The control of filariasis is closely related with the improvement of living standard. Through mass survey and treatment, the W. bancrofti microfilarial rate had dropped from 8.3% in 1956 to 0.76% in 1980 in the most densely populated Xiaoqiao District in Fuzhou city.

Of 59 cases of nervous diseases shown to have complete loss of sensation by classical sensory examinations, 39 were found to have acupuncture sensation. Detection of presence or absence of acupuncture sensation is helpful in judgement of the status of the condition, prediction of its prognosis, differentiation of organic from functional disease, and, as in index for or against surgical treatment, in selection of clinical managements.

Thirty patients with tumors of the lateral ventricle were operated upon in this hospital in a period of ten years, with the tumors totally removed in 24 and subtotally resected in 6. No operative death occurred. Postoperative deep X-ray irradiation and chemotherapy were given to 17 cases. All the 30 cases were followed up for 1-9 years; 19 of them were still surviving up to 1982. Of the 19 survivors, 15 had resumed their work, while the other 4 had to be taken care of. The essential points in diagnosis, treatment as well as method of improving surgical results are discussed.