1985年 · 第98卷第11期

We used arterialization of the venous channel as a treatment method for thromboangiitis obliterans. On the basis of experimental studies, 8 cases of Stage III, Grade II thromboangiitis obliterans were treated by this method with satisfactory results in 6 cases and failure in 2. Arteriography performed at 2, 4 and 7 months after operation respectively showed collateral circulations in the distal part of the limbs. Arterialization of the venous channel is indicated for cases of severe ischemia of the lower extremities. It is contraindicated for cases of deep thrombophlebitis, in whom the venous system of the limbs has been completely impaired, and for diabetic patients whose hyperglycemia has not been well controlled

The authors successfully performed uretero-ileoceco-sigmoidostomy as urinary division in the treatment of bladder cancer, irrepairable cystovaginal fistula and extrophy of the bladder. They also made animal experiments to clarify the mechanism involved in this operation. Results showed that the ileo-cecal valve has an anti-reflux action and the isolated cecum produces a buffering effect. Because the ureteral reflux can be prevented after this operation, the usual complication of ascending infection of the kidney, hyperchloremic acidosis and others can be prevented or decreased.

From March 1972 to June 1982, a consecutive series of 81 patients with atrioventricular canal (a-v canal) malformations underwent intracardiac repair. Among them, seven were ostium primum defects, 70 partial form defects and four complete form defects. Twenty-one patients had associated cardiovascular anomalies with an incidence of 25.9%. Operation was performed under total body per fusion. A constant finding at the operation was primum type low atrial septal defect (ASD). At operation, the ASD was repaired routinely by a dacron patch. Superficial stitches were employed to prevent conduction system damage. Mitral cleft on the aortic leaflet was found in 74 patients, perforation of the tricuspid valve in three and accessory chordae tendineae in two. For the four cases of complete a-v canal, jet was palpated at the ventricular level. For repair of the mitral cleft, two different methods, complete closure and partial approximation of the cleft, were utilized to leave one third of the cleft at its free margin intact. There were four postoperative hospital deaths, all occurring in the category of partial form. The overall mortality was 4.9%. Seventy patients were followed up, showing that the late results in patients with mild-preoperative mitral insufficiency were much better than that in patients with significant insufficiency, and that partial approximation of the mitral cleft might be the method of choice in most cases.

Restriction of motion, mainly adduction, of the hip caused by contracture affecting the M gluteus maximus is not rare. Between 1975 and 1983, we treated 27 patients with this disorder (15 boys, 12 girls; age range: 3-14 years). Their clinical manifestations were characteristic. To release the fibrotic contracture tissue of the M gluteus maximus, all of the patients were treated surgically. The results were satisfactory. The cause of this disorder remains unknown, but the primary cause might be congenital in origin with which some predisposing conditions exist. Besides, the intramuscular injection might additionally play an important role.

Amikacin and other aminoglycoside antibiotics were tested for in vitro antibacterial activity against 480 strains of common pathogens, including S aureus, E coli, Shigella, P aeruginosa, K pneumoniae, Enterobacter, Proteus, etc. The results indicated that home made amikacin was equal in potency to the Japanese made product. The in vitro antibacterial activity of amikacin was markedly superior to that of kanamycin, gentamicin, tobramycin, and streptomycin. Amikacin was active against organisms resistant to gentamicin, tobramycin and kanamycin. Clinical pharmacological studies were performed on 12 cases with normal renal functions. The peak level was 24.75 μg/ml one hour after intramuscular injection of 400 mg amikacin. The biological half life was 2.39-2.48 hours. Thirty-one cases of infections caused by Gram negative rods and S aureus were treated. 87.1% were considered effective. Renal and oto-toxicity was minimal. It is concluded that amikacin is a broad-spectrum, high potency aminoglycoside antibiotic, and is especially suitable for the treatment of severe Gram negative infections and those infections that were caused by gentamicin-tobramycin resistant Gram negative rods.

The fine structures and electron scanning of Leishmania amastigotes and promastigotes isolated from a naturally infected racoon dog (Nytereutes procyonoides Gray) in the suburbs of Beijing were studied and compared with those of a Chinese human strain. They were much similar in fine structures in a number of subpellicular microtubules and in the distance between 2 microtubules. We consider that it may belong to the category of L donovani complex. A kind of multi-vesicular body has been seen in the cytoplasm of amastigotes of both strains but its nature needs further study.

This study was carried out on 22 anesthetized dogs with reversible ligation of the left anterior descending coronary artery to determine the effects of infused Radix puerarin on collateral blood flow to the ischemic myocardium and on systemic hemodynamics. The intravenous infusion of puerarin (10 mg/kg/min) during acute regional myocardial ischemia was associated with a decrease in heart rate from 174±6 to 149±6 beats/min (P<0.001) and in mean arterial pressure from 105±9 to 80±8 mmHg (P<0.01). Despite the decrease in mean arterial pressure, collateral coronary blood flow (radiolabelled microspheres) did not decrease. In 6 right heart bypass experiments in which the hemodynamics were controlled, the infusion of puerarin significantly lowered the tension time index and the rate of rise left ventricular pressure (LVdP/dt). Restoration of systemic blood pressure to the same level that existed prior to the infusion resulted in a substantial increase in collateral flow to ischemic myocardium from 0.55±0.12 to 1.36±0.39 ml/min/g (P<0.05) and an increase in coronary blood flow to nonischemic myocardium from l.11±0,15 to 4.28±1.01 ml/min/g (P<0.05). The diminution of coronary vascular resistance was approximately twice that of systemic arterial resistance (P<0.025). This relative augmentation of coronary dilation is not seen with nitroglycerin. The stroke work (left ventricular end-diastolic pressure relationship) did not change significantly indicating that the infusion of puerarin did not affect myocardial contractility. The results suggest that puerarin lowers resistance to collateral blood flow to regionally ischemic myocardium and climinishes the correlates of myocardial oxygen demand both of which would be expected to have a beneficial effect on ischemic myocardium. The data support the clinical potential of this agent.

Lymphocyte transformation was used after stimulation with mitogen phytohemagglutinin (PHA). Phytohemagglutinin (PHA) was tested on both fresh and frozen aqueous humor from primary open-angle glaucoma (POAG) and cataract patients. Either fresh or frozen aqueous samples from cataract patients showed inhibitory activity. However, 65.3% (32/49) of the fresh POAG aqueous samples presented with inhibition while 36.2% (21/58) frozen aqueous samples presented enhancement of lymphoproliferation (p<0.005).

This is a record of biostatistical data collected during the years 1981-84 at a clinic in the United States, from patients who came to seek acupuncture treatment. The records consist of patient referral, age, sex, main problem, and clinical diagnosis. The information obtained from such records may be of interest to other acupuncture practitioners. It is also hoped that this report will provide useful data in comparing the profiles of those patients in the East and West who seek acupuncture treatment.