1988年 · 第101卷第10期

The antibacterial activity, pharmacokinetic properties, clinical efficacy and safety of netilmicin (NET) are reported. NET was highly active against S. aureus and other Gram positive cocci except Enterococci, and its mean minimal inhibitory concentration (MIC) against most Enterobacteriaceae was 2 mg/L though it was less active against Ps. aeruginosa. Approximately, 25-86% of the strains being resistant to other aminoglycoside (except Ps. aeruginosa) were still sensitive to NET. Peak serum concentrations after a single im or iv drip of 2 mg/kg NET in normal volunteers remained up to 7.6±1.3 and 14.1±8.7 mg/L respectively. The elimination of half life of the drug administrated by both routes was around 2 hours. 85% of the dosage were excreted in urine within 24 hours. 50 patients with various infections were treated with NET with daily dosage of 3-6 mg/kg. The clinical results were 33 cured, 6 markedly improved and 6 improved; the total effective rate was 90To and the bacterial elimination rate 81×. No remarkable oto-or nephrotoxicity were noted. The indications and prospects of the NET were discussed.

In l00 schizophrenic inpatients diagnosed by CMA criteria (1984), the clinical manifestations were compared to the schizophrenia diagnostic criteria proposed by Bleuler, Schneider, Carpenter, St. Louis Feiglmer, Taylor, Spitzer, DSM-III, Xu You-xin, etc. The advantages and disadvantages of these criteria were evaluated. , We suggest that the diagnostic criteria for schizophrenia should be improved. The modified CMA criteria for schizophrenia is valuable for clinical reference but requires further improvement of its validity and reliability.

Twenty-one cases of epidemic viral encephalitis B were studied histologically and immuno-histochemically. Of 15 patients who died during two epidemics 7 were proved by virological tests. Characteristic lesions such as glial nodules, acellular softening and perivascular cuffing were found in routine staining. ABC immunostaining was positive in 13 (62%) patients, one of which had no characteristic histologic lesion. Japanese B encephalitis (JBE) viral antigen was demonstrated in many morphologically normal nerve cells of the brain and cervical spinal cord, particularly in large nerve cells of the brain stem. But when glial nodules occurred in these immunologically positive areas, no nerve cell was seen. Formation of glial nodules appeared to be the result of death of nerve cells. Acellular softening stained negative while the surrounding nerve cells positive, suggesting a possible relationship with immune reaction. The value of this immunostaining for JBE is discussed.

Based on the animal model of coronary artery spasm (CAS)-thrombosis (CATH)-acute myocardial infarction (AMI), the authors tried to prevent experimental CATH and AMI induced by experimental CAS with nifedipine (nif) drip in ergonovine the experimental dogs were divided into two groups: the nif 1 group, nif iv drip at 14 μg/kg/h 15 min after CAS and the nif 2 group, 20.02 μg/kg/h 5 min after CAS with 10 healthy mongrel dogs in each. More marked changes presented in the nif 2 group. Hemodynamically, the main aortic pressure (MAP) left coronary artery pressure (LCAP), left ventricular pressure (LVP), and SVR were all markedly decreased (P<0.05-0.01), CO was enhanced and the S-T segment elevated. Ventricular premature beat (VPB) and auriculoventricular block disappeared 4-30 min after therapy. Oxygen partial presure (PaO2) oxygenssaturation (SaO2) and total platelet count all increased (P<0.05) and platelet aggregation markedly decreased (P<0.05). The TXB2/6 KetoPGFia ratio was kept within normal range. Pathologic evidence of effects: the coronary and myoeardial changes were all milder, ACTH-AMI was successfully prevented and CATH decreased from 53% (CAS group, 9/17) to 30% (nif 1 group), 0% (nif 2 group, 0/10). Ca++ containing bodies in the mitochondria decreased from 40% (CAS group) to 10% (nif 1) and 0% (nif 2). This showed that nif can abort CATH and AMI in experimental CAS, confirming the result in clinical cases.

By contrast immunofluorescent technique, the distribution of SC, IgA and IgA-producing cells was investigated in essentially normal gastric mucosa (19 cases) superficial gastritis (29 cases), atrophic gastritis (24 cases) and gastric carcinoma (48 cases). Excellent results were obtained, conducive to retrospective studies. Fluorescence of SC and IgA was found on the membrane of pyloric glandular epithelial cells along their sides and luminal border, but not in fundic glandular cells. IgA fluorescence alone was found in the cytoplasm of IgA-producting cells and interstices. SC and IgA fluorescence was stronger in the mucosa of superficial gastritis than in normal controls. In the glands with intestinal metaplasia SC and IgA fluorescence was markedly weakened. Among the 48 patients with gastric carcinoma, SC fluorescence was noted in 13 and IgA fluorescence in 16, demonstrated on the luminal surface in well differentiated glandular carcinoma and on the membrane or in the cytoplasm of poorly-differentiated carcinoma cells. It is concluded that some carcinoma cells still retained their function of secreting SC and ability to form SlgA irrespective of their degree of differentation.

352 hip joints from 176 fetuses, 16-40 weeks old, were studied. The joints were dissected and measurements were taken of the depth and diameter of the acetabulum, the diameter of the femoral head, the length and width of the ligament teres, and the neckshaft angle and anteversion angle of the proximal femur. The analysis of the results showed that the development of the acetabulum and femoral head in diameter and of the ligament teres in length were faster than that of the acetabulum in depth. The acetabular depth index was 60.1% in the 16 week-old fetuses and it decreased to 43.8% in full-term ones. This fact indicates that the relative shallow acetabulum might be a pathogenic factor to the congenital dislocation of the hip.

Seven cases of pityrosporum folliculitis are reported. The typical lesions were pruritic erythematous follicular papules and follicular pustules, 2 to 4 mm in diameter, located mainly on the upper trunk. Histopathologic sections showed PAS positive spherical to oval single budding yeast cells in dilated follicles. The follicular wall was ruptured in 1 sample, follicular epithelia were disrupted and yeast cells were seen in the sebaceous glands in 2 samples, and there was cellular infiltration in the sebaceous glands and around the dermic capillaries in all Samples.

It has been proved by the immunohistochemical technique avidin-biotin-peroxidase complex (ABC) that immunostaining for keratin and vimentin is valuable in diagnosing nasopharyngeal carcinoma (NPC). By immunostaining of keratin, epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), 38 cases of NPC were investigated. It was found that as a marker of NPC, keratin is better than EMA and CEA. Besides, the diagnostic value of ABC immunostaining technique and immunogold-silver staining (IGSS) technique was compared. The result indicates that the latter is more practical, economical and sensitive than the former.

The craniofacial resection with a newly designed H-shaped incision was done in two patients with extensive malignant meningioma. The results suggest that the H-shaped incision allows an excellent exposure and is especially suitable for the craniofacial resection of extensive tumors involving the base of the anterior cranial fossa, nasal cavities, paranasal sinuses, and the orbits.