1982年 · 第02卷第03期

This paper deals with some observations on the realtionship between duodenal ulcer (DU) and parietal cell mass (PCM) from both the clinical and experimental points of view. The total number of the subjects under investigation were 113, among whom 65 had DU, 24 had GU and 24 had normal endoscopic gastric and duodenal findings. Gastric analysis was done on these subjects, phenol red used as a marker for measuring the loss through the pylorus. The results of PAO and PCM were calculated. The PCM of the DU group was significantly higher than those of the other two groups. (p<0.01). Thus for the Chinese patients the relationship between PCM and DU is established. To further investigate the relationship between PCM and DU, animal experiments were carried out. The rats were divided into 3 groups: pentagastrin group; antrectomy group and control group, 30 in each. The results showed that the PAO and PCM were significantly greater and the DU induction rate was markedly higher in pentagastrin group. It is concluded that the DU induction rate is significantly related to the PCM.

Seventy-five in-patients with different types of peptic ulcer treated by furazolidone and 31 by gastropin and probanthine as placebo are reported. After 2-week course of medication, 74.7% of the treated patients had their ulcers healed and 22.7% reduced in size; while in the control group, the figures were 70.9% and 19.4% respectively. 2-4 years followup study showed that only 7.69% (4/52) of the treated cases relapsed whereas 33.33% (7/21) of the control group relapsed (p<0.02). Thus, furazolidone gives a better long term efficacy than that of antacid therapy. For the action of furazolidone, gastric mucosal necrosis was induced in Shay rats by intragastric infusion with absolute alcohol and intraperitoneal injection with norepinephrine. The necrosis could be well protected by prior intragastric infusion of furazolidone suspension. It is considered that furazolidone has some cytoprotective action to the gastric mucosa, and this action may play an important role in the treatment of peptic ulcer.

One hundred and eleven cases of gastric ulcer proved pathologically and/ or through surgical operation, including 11 cases of the early ulcerative gastric cancer and 36 cases of the advanced, as well as 64 cases of benign ulcer, were analysed. The results were as follows: (1) the niche of benign ulcer is round or oval in shape with a sharp edge, whereas in gastric cancer, including both the early and the advanced, the crater is usually irregular on front view, (2) the convergent mucosal folds surrounding the benign ulcer on the double contrast film usually show ending up to the edge of the ulcer without thinning or clubbing, whereas in early malignant ulcer, they are nodular in appearance and some of them are coalescent forming a radiotransparent circular dam-like edge, (3) the areas gastricae surrounding the niche are seen uniformly arranged in benign ulcer under the hypotonic double contrast examination, whereas in the malignant ulcer, are irregular and nodular in appearance. In order to make comprehensive study of the niche and its surrounding mucosal folds, the authors suggest that the double contrast examination in addition to the routine X-ray examination of the stomach is recommendable.

Dientamoeba fragilis has long been considered as a rare and innocuous parasite. Through improved fecal examination technique, the detection ratc was increased to 2.2% among 38,075 samples examined from 1973 to 1978. Clinical observations made on 123 cases revealed that 66.7% and 57.7% of them complained of abdominal pain and diarrhea, while 28.5% and 22.8%, loss of appetite or abdominal discomfort and flatulence, respectively. The daily frequency of diarrhea was 2-3 times and the duration of symptoms lasted 1-6 months. Carbarsone was used mainly during the period of 1959-1963 and metronidazole, 1976-1978. The latter drug gave better curative rate, reaching 92.7% when used at the dosage of 400 mg three times daily for 7 days. The authors reviewed 4,000 cases of Dientamoeba fragilis infection so far recorded in the literature and the taxonomic situation of the parasite, its mode of transmission, morbidity and treatment were discussed.

The serum free tryptophan was determined in 4 groups of patients. In 19 patients with hepatic coma (grade Ⅲ, Ⅳ), the levels of free tryptophan all exceeded 15 μM/L. In 41 patients with coma caused by cerebral hemorrhage, encephalitis, uremia, sepsis and other diseases, the levels of free tryptophan were not reached 13 μM/L except one (17 μM/L) who was suffering from uremia complicated with abnormal liver function. The free tryptophan exceeded 7.8 μM/L in all 14 patients with hepatic encephalopathy (grade I, II), but did not exceed 5.9 μM/Lin 10 patients with schizophrenia. The marked difference between the hepatic encephalopathy and the other encephalopathy is of some significance in differential diagnosis of hepatic coma. Assessment of total tryptophan, free fatty acid and albumin were also made.

This paper deals with the detection of hepatitis B antibody to core antigen by enzym-linked immunosorbent assay (ELISA). The results show that this method possesses the advantages of having high specificity, sensitivity comparable to immune adherence hemoagglutination assay (IAHA), good reproducibility, long effective period of reagents, no requirement for a special counting equipement, and simplicity and feasibility. Therefore, it can be recommended to be used for routine and large scale examination.

This paper summarizes the experiences of 34 operations on 21 cases of choledochal cyst in the past 16 years. External drainage of the cyst was effective in controlling acute inflammation. It is the operation of choice in emergency. Of the 13 cases with internal drainage of the cyst, carcinoma of the biliary tract occurred in 3 and liver cancer in 2. Resection of the cyst can relieve retention of bile without pancreatic-biliary reflux. Of the 7 cases undergoing resection, there were no operative mortality and no recurrence of symptoms. Hence resection of the cyst should be considered as the first choice of operation.