1987年 · 第100卷第04期

One-stage reconstruction of the penis with the abdominal fasciocutaneous flap based on the arteria epigastrica superficialis (AES) and arteria circum-flexa ilium superficialis (ACIS) was performed with success in 16 patients. The flap, table-tennis-bat shaped, was taken from the lower quadrant of the abdomen. The blood for the flap was supplied by the AES and the ACIS. "The striking surface of the bat" constituted the main part of the flap; the medial portion of which formed the corpus penis and the lateral portion formed the urethra. The supporting tissue was a piece of autogenous cartilage or a silicon rubber bar. The reconstructed penis assumed an acceptable appearance and was good in function.

Lower leg lateral skin flaps were used in 7 patients since January 1983. Satisfactory results were obtained. The blood supply of the flap was based on the peroneal artery, which gives rise to cutaneous or musculocutaneous branches to nourish the flap. The venous blood of the flap was drained by the venae comites accompanying these cutaneous or musculocutaneous branches. In clinical practice, the beginning portion of the peroneal artery and the vein arising from the posterior tibial vein are used for vascular anastomosis. The caliber of the peroneal artery is 2.5-3.0 mm, and that of the peroneal vein is 3-4 mm. The vascular pedicle is 8-12 cm long. In 4 of these patients, the flaps were freely transferred using a microvascular technique; in the remaining 3, a reversed transfer for treating defects over the foot was used.

This report describes a 28-year-old female with recurrent persistent ventricular tachycardia refractory to conventional antiarrhythmics and overdrive pacing. The ventricular tachycardia ectopic focus was localized by endocardial mapping and ablated by catheter fulguration. One 300J direct-current shock was delivered to the endocardial region where catheter pressing eliminated the tachycardia. At 3 month follow-up the patient is asymptomatic and without recurrence. It is suggested that in patients with refractory ventricular tachycardia, catheter ablation of the ectopic focus is a feasible alternative to ablative surgery

The dependence of the prostate on testicular function has been well documented for years. In the 1930's Huggins performed classical studies on the hormone regulation of the prostate. Those studies were based on animal experiments and led to endocrine treatment of prostatic cancer. So far, however, very little is known about the long-term reaction of the noncancerous human prostate to androgen deprivation. Is there any difference if castration is done before or after puberty? At Beijing Medical College we had a unique opportunity to study a number of eunuchs 41-65 years after castration.

Among 1,399 cases of gastric carcinoma, 67 (4.8%) were of the superficial type and 1,332 (95.2%) the progressive type. Gastrectomy was performed in 1,105 cases (79%), 834 of them (59.5%) underwent radical resection with an operative mortality of 1.7%. The 5-, 10 and 15- year survival rates were 53.8%, 50.1% and 49% respectively. The resectional procedures adopted included: R1 in 291 cases, R2 in 383, selective R3 in 145, and R3 in 15. The 5-year survival rates of the procedures were 30.3%, 57.7%, 71.8% and 55.7%. The 5-year survival rates of patients with superficial gastric carcinoma and Grades I, II, III. and IV progressive carcinoma were 98.2%, 96.3%, 85%, 37.4% and 22.2%. There was no significant difference in survival rates between various types of surgery (p>0.05) for patients with superficial and Grades I and II gastric carcinoma. Results of selective R3 and R3 procedures performed were superior to those of R2 procedure for patients with Grade III carcinoma, however, the latter were superior to those of R1 for the same type of patients (p<0.01). With respect to Grade IV carcinoma, selective R3 and R3 operations had significantly higher 3-year survival rates as compared to R2 and R1 (p<0.01). The 1-year and 3-year survival rates in cases treated with combined surgery and chemotherapy were significantly higher than those treated with operation alone (p<0.01).

Fifty rats were used for the study of behavior alterations and histopathologic changes in the spinal cord after transection of the thoracic spinal cord at level T12. Observations were made by light microscope and transmission electron microscope. Three stages of scar formation were recognized at the site of the transection. The first stage occurred from 10-30 days after the operation. Proliferation of neuroglia and connective tissue were the essential feature of this stage; the second stage was from 2 to 3 months after surgery and began with organization of the scar tissue. Connective tissue cells decreased and collagen fibers increased in the third or post organization stage, occurring 6 to 9 months after transection, Collagen fibers and foci of neuroglia were the main findings. There were more or less regenerative (or recovery) reaction of the nervous tissue in the site adjacent to the transection, and of the neuropils and perikaryons at C4 and L4 levels from 3 to 9 months after surgery. From 4 to 6 months after transection some clumsy and uncoordinated movements appeared in the hind limbs, which may be related to regeneration in the lumbar spinal cord gray matter.

Hanjisong (HJS) is anondepolarizing muscle relaxant. It is extracted from Radix Stephaniae Tetrandrae (汉防已) in the form of a quaternary ammonium salt of the alkaloid tetrandrine. Chemically it is tetrandrine dimethiodide, and in Chinese is called Hanjisong (汉肌松), the molecular formula is C40H48O6N2I2 and molecluar weight is 906.64.

HLA-A,B typing was studied on 100 unrelated Graves' disease patients of Han Nationality in Hangzhou. 100 healthy donors served as controls. A marked increase in the frequency of HLA-A11 antigen was observed in patients with Graves' disease which was consistant and significantly different from the normal, even after correction This showed a close association between HLA-A11 and Graves' disease. The frequency of B35 antigen tended to decrease in patients with Graves' disease as compared with the controls after correction. A negative correlation was found between HLA-B35 and Graves' disease.

Computed tomographic (CT) findings in 51 cases of surgically and histologically confirmed intraventricular tumors were analysed. Meningiomas were most common in the trigone of the lateral ventricle in adults (84.2%), predominantly in adult females, appearing as hyperdense, well-defined, and homo genously enhanced masses. Astrocytomas frequently thickened the septum pellucidum and generally involved the frontal horns and anterior portion of the body of the lateral ventricle. Ependymomas were most common in the fourth ventricle in children, presenting often as isodense and nonhomogeneously enhanced masses. Papillomas of the choroid plexus mainly involved the trigone of the lateral ventricle in children complicated by markedly communicative hydrocephalus, whereas in adults they were more frequently located in the fourth ventricle. Differential diagnosis of intra and extraventricular tumors and qualitative diagnosis of intraventricular tumors are discussed.

12 cases of inverted tumor of the urinary bladder collected from 300 cases of transitional cell tumors and tumor-like lesions seen in the years 1975-1984 in Tianjin Medical College were reported. The term "inverted tumor" of the bladder is newly coined by the authors to define the tumor. Its histological morphology is different in some respects from "inverted papilloma of the bladder," though it was grouped as such in the past. The anthors suggested a new classification of the inverted tumor of the bladder based upon materials held.