1986年 · 第06卷第01期

The fasting blood sugar (BS), oral glucose tolerance test (OGTT), serum insulin (IRI), C-peptide (C-P), glucagon (IRG) and IRI/BS, C-P/IRI, IRI/IRG ratios were observed in 93 cases with hepatitis including 45 acute hepatitis, 23 chronic active hepatitis (CAH) and 25 chronic persistent hepatitis (CPH), and 53 normals as control. It was shown that the area under the curves of OGTT were much higher in the acute hepatitis and CAH groups than the normal control (p<0.01). All 3 groups of hepatitis had hyperinsulinemia, hyperpeptidemia and hyperglucagonemia. The IRI/BS ratio was higher in acute hepatis and CAH groups than that in normal control (p<0.001). The values of bilirubin, BS, IRI and IRG were studied showing positive correlation. The related examinations indicate that the acute and chronic hepatitis may associate with reduction of OGTT, particularly in CAH. The results suggest that: 1. the hyperinsulinemia, hyperglucagonemia could not be explained by the porto-cavashunt: 2. the hyperfunction state of pancreatic A and B cells may exist in the course of hepatitits, which may act as a cause of hyperinsulinemia and hyperglucagonemia in patients with hepatitis: 3. the acute damage of liver cells may be significant in hyperglucogonemia: 4. the treatment of hepatitis with glucose-insulin and with glucogon should be reconsidered.

Twelve kinds of plasma protein in 192 patients with hepatitis in various stages or liver cirrhosis were determined and compared with the normal controls. The results showed that in both hepatitic and cirrhotic patients and especially in patients with CAH and cirrhosis, the levels of all the 12 proteins differed from normal. The levels of plasma albumin, transferrin, heptoglobin and α₁- acid glycoprotein decreased with the progression of liver damage, while the levels of plasma CRP and β₂- m increased with the activaton and perpetuation of the disease process. Thus the determination of the aforementioned components are valuable in evaluating the degree of liver damage and estimating the activation and perpetuation of the disease process respectively. Various complement components changes were also observed in both hepatitis and cirrhotic patients.

Serum pancreatic polypeptide (PP) both at fasting state and after giving atropine (7μg/kg) were measured in 83 cases with duodenal ulcer (DU) and 72 normal controls. The mean value of basal PP in DU was increased and its value after atropine treatment returned to normal. A significant positive correlation existed between the basal PP and the decrement of PP after atropine (r = 0.904, p<0.0001). Maximal acid output (MAO) correlated well with basal PP and PP decrement in subjects under the age of 50. The results show that vagal hyperfunction exists in patients and plays an important role in hypersecretion of parietal cell. It is suggested that the determination of basal PP combined with atropine test may be helpful in sorting out a subgroup of DU with increased vagal tone.

The mutagenicity of cimetidine and its nitroso metabolites was investigated by sister chromatid exchange (SCE) analysis in human peripheral lymphocytes. The results showed that cimetidine induced a statisticaly significant increase of SCE frequency both in vitro and in vivo studies. After addition of cimetidine and sodium nitrite into fasting gastric jucie of D. U. patients, a product with the same chromatographic character as nitroso-ckmetidine was found in 5/7 samples. The SCE inducing capacity of this product was stronger than that of cimetidine. Evidence for the formation of this product in the stomach of D. U. patients in vivo was found in neither of the five cases examied.

In order to assess the efficacy of ranitidine (made in China) in the treatment of peptic ulcer, 270 cases of peptic ulcer were divided into two groups. 201 cases were treated with ranitidine 0.15 mg bid orally, and 69 cases were treated with cimetidine 0.2 tid and 0.4 at noct. After a course of 6 weeks' treatment, tu endoscopic healing rates of gastric duodenal ulcers were 91% and 82% in the ranitidine group, and 86% and 77% in the cimetidine group respectively. The difference of effectiveness for gastric and duodenal ulcer between the 2 groups was not statistically significant.

In the ranitidine treated group, dizziness, constipation, drowsyness and diarrhea were seen in a few cases during the treatment but all were mild. No change in the prodile of hematology and renal function was found. A slight and transient elevation of transaminase was noted in 4 cases. Our data indicate that home made ranitidine is as effective as Glaxo product.

6480 resected gastric specimens were collected in 3 hospitals, of which 109 cases with gastric schistosomiasis were clinically and pathologically analyzed in order to investigate the relation between gastric schistosomiasis and gastric cancer. The histological findings suggested the existence of certain relationship between schistosomiasis and gastric malignancy. The ova mostly remained in the mucosal layer of the gastric wall. An intense hyperplasia of mucosa caused by the chronic inflammation may progress to pseudopolyp formation. Within the polyps and surrounding adenoepithelium, anatypical hyperplasia and dysplasia may lead to carcinogenesis. The ova of the schistosome are, therefore, considered to be one of the factors in the development of gastric cancer.

It is believed that amino acid determination may be valuable in estimating the hepato-cellular function and/or the degree of liver cell necrosis, and consequently it may be helpful in prognostication and guiding the treatment. In the present study, 20 amino acids were assayed by high performance liquid chromatography for each of 60 patients with acute or chronic liver diseases, and the levels of BCAA, AAA, and BCAA/AAA ratio were correlated with the test results of blood NH₃, albumin, globulin, prothrombin time, serum cholinesterase, bilirubin and SGPT. The data were treatmed by stepwise regression analysis. We have found that there are definite correlations between them.

From July 1976 to May 1985, 46 cases of gastric schistosomiasis proved by pathological sections were collected. Eighteen of them were co-existed with gastric carcinoma, 17 with peptic ulcer, 10 with gastritis and one with leiomyoma. Moderate inflammation in the tissue around the eggs were observed in all cases. In 16 cases, eggs were deposited in the middle or around the edge of the tumor tissues, There were transitional changes and atypical proliferation denoting transformation toward carcinomatous change. In 12 cases, eggs were deposited in the middle or around the edge of ulcers. The authors consider that there is some relationship between oval deposition and development of gastric carcinoma, ulcer and gastritis.

There is no clinical and roentgenologic characteristics of gastric schistosomiasis and therefore gastroscopy with biopsyis the only method for a definite diagnosis of the disease.

We have designed a tryotophan tolerancetest by giving an intravenous loading dose of tryptophan of 4 mg/kg body weight (ITrpTT), followed by determination of serum levels of free (F) and total (T) tryptophan at 45 and 60 min to observe its pattern of clearance. Any value of F 45 (60)>7μmol/L and/or T 45 (60)>80μmol/L and/or F/T>0.14 was considered abnormal. Totally 35 patients wth various liver diseases were subjectied to the study with 69 normals as control. It has been found a 87.5—100% consistent changing pattern of clearance in chronic liver disease with increase of T 45 (60) in CPH increase of F 45 (60) and F/T ratio in cirrhosis. It has also been found that it is useful in distinguishing PHC from benign hemangioma of the liver, as the former has a changing pattern of cirrhosis and the latter a normal pattern of metabolism. It is concluded that ITrpTT can be considered as a physiologic liver function test since tryptophan is a natural amino acid component of proteins, it is a more sensitive liver function test than the conventional ones and this test is helpful in diferentiating PHC from benign tumor of the liver.