1989年 · 第102卷第02期

The possible role of human papilloma virus (HPV) and herpes simplex virus type 2 (HSV-2) in the viral etiology of cervical carcinoma was investigated a series of cervical lesions were studied for the presence of HPV and HSV-2 DNA sequences as well as HPV and HSV-2 antingens by DNA dot blot hybridization technique and high-specificity PAP staining method. The results obtained were correlated with the histologic diagnosis. HPV 16 DNA sequences detected in cervical carcinoma biopsies were 43%, whereas HSV-2 DNA sequences were only 8%. HPV antigens detected in cervical dysplasia were 31%, whereas those detected in cervical carcinoma and cervicitis were the least. HSV-2 antigens were detected in chronic cervicitis, dysplasia and cervical carcinoma. The difference in positive rate between the cervical carcinoma and cervicitis groups was statistically significant. (chi-square test, P<0.01). No HPV DNA and HSV-2 DNA sequences were found in the same specimen, although both HPV DNA sequences and HSV-2 antigens were found in the same sample in some cases. The results indicate that the viral etiology of cervical carcinoma may be multifactorial. Both HSV-2 and HPV may be associated with cervical carcinoma, but the mechanisms involved are different. HSV-2 and HPV may act synergistically in the development of cervical carcinoma.

Satisfactory results have been obtained in treating infective shock with injection of natural Fructus Aurantii immaturus (nat-FAI). The results of animal experiments and clinical observations on the anti-shock effects of the synthetic effective compositions of Fructus Aurantii immaturus (syn-FAI) are reported. The cardiac output increased from 0.53 to 0.87 L/min (P<0.01), and the cardiac index increased from 0.99 to 1.63 L/m2/min (P<0.01) in the endotoxic shock dogs after the treatment with, syn-FAI. At the same time the blood stream in bulbar conjunctiva became accelerated and the dilated microvessels began to get smaller in most dogs. Of fifty children with infective shock treated with syn-FAI, forty-eight showed curative effects, with a total effective rate of 96%. The anti-shock effective compositions in FAI have been proved to be synephrine and N-methyltyrosamine. Moreover, syn-FAI has shown a more stable property, less side-effects and better clinical results than nat-FAI.

The creation of an experimental animal model of traumatic chylothorax was verified by 131I labelled fat (peanut oil). 15 dogs of 3 groups were administered 131I labelled oil via a gastric tube. The results were compared between the two experimental groups and a control group with nonchylous pleural effusion. Dynamic radioactive studies on the blood and pleural fluid showed that the absorption curve of the dog’s blood and chyle to 131I labelled oil was identical regardless of different attitudes, and was also similar to that of the human blood because the peak appeared 4 hours after the administration of 131I labelled oil, at which the radioactivity of chyle reached its maximum, more powerful than that of the blood collected at the same time (P<0.01). The 99% confidence limitation of radioactivity of the pleural fluid, and the radioactivity ratio of the pleural fluid to blood in the experimental groups were l.8-10.5 and 493-2340 cpm respectively. The specific characteristics of chyle was then determined qualitatively according to the quantitative norms. We conclude that the technique is parallel with the normal physiological pattern and seems to be more simple and reliable than methods for detection of intraoperative injury of the thoracic duct and early diagnosis of postoperative chylothorax.

Antiepilepsirine (AES) is one of the derivatives of a Chinese folk prescription. It is a new antiepileptic drug (AED) synthesized in cooperation by Chinese medical and pharmaceutical workers. Pharmacological experiments on animal models prove that its antiepileptic action is marked, but there has been little evaluation of its clinical effects. We used the double-blind placebo-controlled crossover study which is generally acceptable as a proper method for new drug study. This study covered 58 epileptic children treated with classical AEDs and observed 6.5 months. Every patient took AES and placebo for 3 months each by random crossover on the basis of add-on therapy. The blood levels of AES and other antiepileptic drugs were determined regularly. The results show that there are no significant differences in clinical effects between AES and placebo in pediatric epilepsies as a whole, but AES is effective in tonic-clonic seizures (P<0.05), the most common type of seizure in the series. There are no significant differences in AED blood levels between the AES effective and ineffective groups. AES has no effect on the blood levels of other AEDS. AES is very safe, children given large doses(10 mg/kg/day) demonstrate no serious side-effects. It is suggested that there is potential improvement in patient psychological and cognitive status. This article also discusses the evaluation of new drugs for clinical effects, subject sampling, the criteria for efficacy evaluation and relationship between animal information and human outcome. The AES chemical structure is different from other well-known AEDs, this is a unique advantage. It will offer a new approach to treating epilepsy by using traditional Chinese medicinal herbs if we tailor the AES structure to make it more effective and safe.

Thallium-201 dipyridamole test (T1-201DT) has high sensitivity and specificity in the assessment of coronary disease (CAD), but is not always available. We proposed impedance cardiography DT (IDT) instead. To determine the characteristic changes of impedance cardiogram (ICG) in patients with typical angina and to compare with those in normal subjects, 37 subjects undergoing IDT were divided into 3 groups: typical angina (15), suspected chest pain (11) and normals (11). Dipyridamole (DP) was infused intravenously for over 10 minutes at a total dose of 0.75 mg/kg. Simultaneous recording of ECG, PCG, and ICG were repeated immediately 2 minutes and 4 minutes after infusion of DP, and immediately and 5 minutes after intravenous infusion of aminophylline. Eleven parameters, HR, SPRP, QZ/ZA2, HI, SV, CO, A wave, A/C, O wave, O/C, A+O/C were observed. Only in O/C and A+O/C there were changes of significant differences (P<0.01) between groups. Specificity was 100% (0/11 positive) in normals. Sensitivity was 80% (12/15 positive) in the angina group, but only 46.7% (7/15) with ECG. The characteristic changes in CAD patients during IDT were angina induced by DP, abnormal O wave on ICG and change from deep A wave to abnormal Owave. No serious complication occurred after IDT. Our results indicate that IDT is a simple, practical and valuable method for detecting CAD.

In 1985, we applied an arterialized vein stem free flap in 4 cases with success in 3. In making this flap the superficial vein with the covered skin of the limb was used. In operation the flap was inverted and the 2 ends of the vein stem were anastomosed with the artery of the recipient area. Rapid arterial blood flow not only provided blood supply to the flap, but through the "venous network shunt" and "tidal pressure difference of artery" maintained blood circulation of the flap. The details of technique and the changes of blood circulation after flap transfer are described, as are indications advantages and mechanism of blood circulation of the flap, and factors affecting the circulation.

β-endorphin-like immunoreactivity(β-ELI) was measured in the cerebrospinal fluid (CSF) of 36 patients with acute head injury and 12 controls. The mean values of β-ELI in CSF of controls and patients with moderate and severe acute head injury were 51.9±5.6 pg/ml, 110.5 pg/ml, and 173.8±20.1 pg/ml respectively, with significant difference between them (p<0.05). The results showed that β-ELI increased in CSF of acute head injury patients.

Using humoral immunity (γ-globulin 18 cases, IgG, IgA, IgM each 30 cases, CH50, C3, C4 each 29 cases and CIC 31 cases), cellular immunity (E-RFC 68 cases, As 30 cases, SmIg, SmIgG each 18 cases, IMIT 30 cases) and immunopathological manifestations (light microscope, fluorescence microscope, transmitted electron microscope each 7 cases) as indices, we studied the immunological changes of "progressing", "remittent" and "stabilized" groups of patients with thromboangiitis obliterans (TAO) in different stages. Humoral immunity indicated that γ-globulin, immune complex and IgG were all increased; cellular immunity indicated that the rate of T cells and suppressor cells was declined, while that of B cells was elevated. Immunopathologically, under light microscope all the layers of involved vessels were infiltrated with neutrophils, lymphocytes and monocytes; under flourescene and electron microscope, immune complexes were found in the involved vessel walls. Our preliminary results suggest that TAO is an autoimmune disease relevant to antigen-antibody complex.

A cross-sectional study was conducted to examine the rate of cytomegalovirus (CMV) shedding through breast feeding and the rate of acquired infection by the infants. Among the 104 seropositive breast-feeding mothers, CMV was recovered in the milk in 19 cases, with a milk shedding rate of 18.3%. Isolation of CMV from the urine of the infants of the 188 seropositive mothers found 36 positive cases. Of the 36 cases, 15 0f 19 fed on CMV-positive milk were infected through breast-feeding, with an infection rate of 78.9%; 11 of the 85 fed on CMV-negative milk were infected, the infection rate being 12.9%; and 10 (11.9%) of 84 fed on cow's milk were infected. These demonstrate that the rate of infection in infants fed on virus~positive milk was significantly higher than those fed on virus-negative milk or cow's milk (P<0.005).