1986年 · 第99卷第04期

520 patients with intracranial aneurysm were operated upon and analyzed in respect to the location, shape and size of aneurysms, coexistent diseases, vascular spasm and bleeding. Aneurysm of carotid-posterior communicating artery was seen in 53.6% of the patients, and saccular shaped aneurysm in 64.6%. Aneurysms in 76% of the patients were less than 15 mm in diameter; 53.4% of the patients had secondary hemorrhage within 14 days after the first rupture, and 65% had spasm of the parent vessel proximal to the aneurysm. A straight linear fronto-temporal incision with a 4×4 cm bone window was made to clip most aneurysms of the circle of Willis. Extra-intracranial arterial anastomosis was performed before clipping giant aneurysm from major arteries. Copper wire was successively in ducted into two giant aneurysms.

Anti-erythrocyte rosette assay was used to sub divide stromal cells (StCs) of cultured giant cell tumor (GCT) of bone into two groups, the rosette forming cells (RFCs) and non-rosette forming cells (NRFCs). Characteristics of Feulgen-DNA content, 3H-TdR uptake and ultrastructure of different cellular elements in GCT were then investigated by micro-spectrophotometry, autoradiography and both TEM and SEM. Two types of StCs and multinucleated giant cells (MGCs) showed 2C DNA stem line, which contrasted strikingly with aneuploid DNA in osteosarcoma cells. Autoradiography revealed that the labelling index of NRFCs increased with the time of 3H-TdR incorporation in vitro, while RFCs and MGCs were scarcely tagged. The two types of StCs were distinctly different in both surface and intra-cellular structures. The phagocytic function and surface appearance of RFCs resembled those of macrophages, and no polymorphism was found in RFCs. These facts suggest that NRFCs are the neoplastic element in GCT, whereas RFCs are the end-stage cells and possibly the macrophages related to tumor immunity.

We studied the relationship between breast parenchymal pattern and the incidence of breast cancer. The material included 1,564 normal subjects of a mass survey and 552 pathologically proved cases. The incidence of breast parenchymal patterns of the two groups was compared and no relationship was shown between dense type and breast cancer. The "high risk group" opinion remains to be proved. We find that clinical management of breast disease and mass surveys can not be based on breast X-ray parenchymal pattern.

An authoritative monograph on the history; epidemiology including distribution, patient age, prevalence, sources of infection, vectors; clinical aspects including incubation period, typical cases and unusual forms (lymph gland, depigmented macular type, maculo-papular nodular type and mucocutaneous leishmaniasis), importance of mitosis of the mono nuclear-phagocyte system cells containing Leishmania amastigotes, hypersplenism and pathogenesis of pancytopenia in visceral leishmaniasis, complications (noma, agranulocytosis, acute bacillary dysentery and pneumonia), treatment (chemotherapy, splenectomy and treatment of complications); post 1949 legislature to facillitate free and effective treatment, killing of dogs and interruption of transmission route. The disease was not reported in China until the late 19th century. Now it is mainly found in the northwest in Xiujiang, and Inner mongolia and other isolated areas north of the Yangtze River.

α-hANP (α-human atrial natriuretic polypeptide) is one of the potent peptide hormones produced by human atrium, which has been proved to have hypotensive, cardio-depressive, natriuretic and diuretic effects experimentally in vivo. However, there has been no reports so far concerning the clinical use of α-hANP for the treatment of heart failure patients with edema and oliguria. Not long before, we had conducted an investigation on the effects of synthetic α-hANP given intravenously to three normal volunteers under close clinical observations and monitoring without any side effects. On this basis, on September 28, 1985, we administered α-hANP to a patient diagnosed as having severe hypertensive heart disease with failure, with renal arteriosclerosis, oliguria and azotemia. The patient had received sodium nitroprusside and furosemide for several days without any improvement. After the administration of α-hANP, his cardiac functions and pulmonary edema improved, diuresis was prominent, and Na output increased, but there were no marked changes in blood pressure and serum K and Cl. This is the first case report in our country. We believe that a-hANP has somewhat similar effects as shown in animal experiments.

The liver tissue of 20 cases of primary hepato-cellular carcinoma (PHC) was studied electron micro-scopically. Ultrastructural data were correlated to the stages of the cancer and differentiation of the cancer cells, clinical/serological assays, and light microscopic findings. Light and electron microscopy agreed well in classifying the degree of differentiation in cases of relatively well differentiated tumor cells, but not in the less differentiated (e.g. beyond Stage II). For cases with poor differentiation (Stage III or IV), no obvious agreement was observed. Furthermore, the presence of hepatitis B surface antigen in the serum of patients did not show any correspondence to the various degrees of cytoplasmic differentiation of the tumor cells. However, all but 1 of the 8 cases of poorly differentiated tumors were electron microscopically alpha-fetoprotein positive. A number of characteristic changes, typical of the cells in PHC were noted. The nucleus was abnormal in shape. The nuclear membrane showed alterations from indentation to deep lobulation. These changes were not observed in cells of normal liver nor in cells located outside the tumor tissue of cancerous livers. Tight junctions and junctional complexes were irregularly spaced and, since they were increased in length, they described the contorted track of the cell surfaces. The Disse's space was identifiable in all well differentiated cells, but was often filled with fibrous material. Cells out side of the tumor area also showed remarkable changes, such as significantly increased numbers of lysosomes, microbodies and lipid droplets. Often collagen fibers were present in the sinusoids of these cells. In 2 cases the cells revealed particles resembling virus capside, or virions, of 23 nm and 40 to 50 nm in diameter.

The evolution of a schistosomiasis endemic area takes the following patterns: it starts as a snail positive but patient negative area and as the source of infection is continuously introduced, it gradually develops into an endemic focus. As patients increase so does the endemic area, until all snail breeding grounds are heavily infected. Schistosomiasis spreads from the centers to the periphery or in certain directions according to the topography. Isolated snail positive but patient negative foci far from endemic areas are not likely to become endemic unless some fundamental changes take place. The part which snails play in different situations should be studied in order to take approriate measures for their control. In established endemic areas, the first step is eradication of the source of infection by treating all patients and infected cattle to save human life and prevent economic loss and prevent aggravation and spread of endemicity. The next step is to prevent snails at the middle and feet of mountains or hills from spreading to the plains and basins, especially to inhabited villages and cultivated fields.

59 cases of rheumatoid arthritis, ankylosing spondylitis and juvenile rheumatoid arthritis treated with the Chinese herb Radix Tripterygium Wilfordii Hook F (RTWHF 雷公藤) showed high rates of successful control of joint pain and swelling and functional improvement with few serious or irreversible side effects. No permanent damage to the heart, liver, kidneys or bone marrow was observed although this may be due to selection of patients who tolerate the drug well. RTWHF seems to be the drug of choice although it should be used with caution in young adults as it can cause amenorrhea in women and cut sperm count in men, perhaps due to sexual gland functional impairment. The total glycosides are reported to be less toxic than the whole herb, so further study is necessary to isolate the effective constituents necessary to clinical usage.

In 52 patients with chronic renal failure (CRF) it was found that the total number of peripheral blood lymphocytes and absolute number of unfractionated T lymphocytes and Tm subsets were markedly reduced; the Tg subpopulation tended to be increased; the proportion of Fc receptor-bearing K lymphocytes was significantly increased; PHA induced lymphocyte transformation was markedly suppressed; and serum IgG levels were very significantly lowered. Reduced numbers of Tm cells with insufficient helper function appears to be an important feature of impaired cellular immunity in CRF.

38 hybrid dogs were injected intravenously with oleic acid 0.03 mg/kg body weight to induce experimental respiratory distress syndrome. The animals were divided into four groups, one was the control group and the other three groups were treated with dexamethasone, scopolamine hydrobromide and anisodamine. The animals were killed 24 hours after injection. The blood gas parameters of arterial and mixed venous blood were determined before, immediately and 0.5, 1, 2, 4, 6, 22, and 24 hours after oleic acid injection. The average pulmonary arterial pressure was measured hourly. Chest X-rays were taken before and 2, 4, 6, and 24 hours after injection. The histological specimens of the killed animals were examined by light and electron microscopy. It was found that dexamethasone and anisodamine are effective in treating experimental respiratory distress syndrome while scopolamine is rather disappointing.