1989年 · 第102卷第04期

The in vitro antibacterial activity of 19 antimicrobial agents against 40 strains of P aeruginosa was studied. The 19 antimicrobial agents included 7 semisynthetic penicillins, 6 third generation cephalosporins, 5 aminoglycosides and 1 quinolone agent. The minimal inhibition concentrations (MIGs) were measured by the serial dilution on solid agar. Ceftazidime was the most active in 19 antimicrobial agents again P aeruginosa (MIC50: 1 pg/ml, MIC90: 2 μg/ml) Amikacin and ofloxaxin followed it in activity. Acylureido-penicillins, such as azlocillin, furbenicillin and piperacillin were highly active against P aeruginosa, which could inhibit, 92.5%, 90% and 85% of these strains at a concentration of 8 µg/ml. Cefsulodine and cefoperazone were also active against the same strains, inhibiting 92.5% and 99% of the strains at a concentration of 8 µg/ml. The potency of the agents mentioned above against P. aeruginosa was similar to that of aminoglycosides. The drug susceptibility of 10 strains isolated in our hospital was compared with that of 29 strains of other hospitals in Beijing. The MICS of 5 penicillins and 3 cephalosporins against the isolates of our hospital was higher than that of other hospitals, suggesting that the susceptibility of β-lactam antibiotics against isolates of our hospital was lower. The effects of combined use of azlocillin with oxacillin and piperacillin with ofloxacin against 4 strains of carbenicillin-resistant P aeruginosa was studied using check-board testing. The synergy and partial synergy were observed in both combinations.

Pre- and postoperative hypothalamic-pituitary-thyroid axis function was studied in 38 patients with pituitary adenomas (PRL, GH and ACTH tumours), of whom 35 were surgically confirmed and three diagnosed by clinical signs, CT scanning and hormone assessments. About ten days after operation, the same study was repeated in 10 patients with prolactinoma and 7 with growth hormone (GH) tumour. The preoperative abnormal serum TSH response to TRH was found in 8/20 patients with prolactinoma, 9/16 with GH tumour, and 2/2 with Cushing's disease due to ACTH microadenoma. The incidence of abnormal TSH reponse to TRH was not significantly increased in patients with larger adenoma in either PRL or GH tumour group. In 8 cases of prolactinoma, metoclopramide (MCP, 10 mg, P.O.) test was also performed and there was a significant positive correlation between TSH responses to TRH and to MCP. Serum TT3 in the GH tumour group was within normal ranges, but significantly higher than that of the normal and prolactinoma groups. After operation, TT3 was significantly decreased as compared with that before operation and there were marked changes in TSH response to TRH. In conclusion, there were some abnormalities in TSH control in patients with non-TSH pituitary tumour, and in serum TT3 control in patients with GH tumour. The surgical treatment of pituitary adenoma can lead to transient decrease in TSH reserve and serum TT3 level probably resulting from both stress and/or destruction of thyrotrophs by the operation.

A patient with vascular disease of the brain due to allergic vasculitis, which had been misdiagnosed for many years, was given anti-inflammatory, antituberculosis and antitumor drugs with no avail. He was admitted this time for an attack after eating food prepared with leftover oil used for frying hairtail. Considering the possibility of allergic vasculitis, we tried antianaphylactics and immunosuppression drugs including dexamethasone with satisfactory results. The Final diagnosis was allergic granulomatous vasculitis.

Malignant ascites in patients with advanced or recurrent ovarian cancer poses a common problem to gynecologic oncologists. The traditional treatment with diuretics, salt, and fluid restriction is rarely effective. The patients usually undergo repeated paracentesis, resulting in the imbalance of protein and electrolytes. We treated a patient with ovarian malignant ascites by using a double valve Denver peritoneal venous shunt with satisfactory results.

External counter-pulsation therapy was applied to 12 cases of progressive muscular dystrophy with effects of varying degressive markably effective in 3 cases, effective in 6, improved in 2 and no effect in one. In 11 of 12 cases the atrophic muscles became normal, in 3 of 8 cases the gastrocnemius softened and in 9 of 10 cases creatine phosphokinase greatly reduced. Electron microscopy found that the ultramicrostructure of the diseased muscles greatly improved, the structure and morphology of most mitochondria became normal, and glycogenesis disappeared.

Using the thyroid microsomal antigen (TMAg) prepared by affinity chromatographygel filtration method of sufficient purity, we measured the TM antibody (TMAb) level by an enzyme-linked immunosorbent assay (ELISA) in 103 normal persons and 183 patients with various thyroid disorders (Hashimoto's thyroiditis, Graves' disease, hypothyroidism, subacute thyroiditis, thyroid cancer, thyroid adenoma and simple goiter). The thyroglobulin antibody (TCAb). T3 and T4 were also measured at the same time. Based on the measurement of TMAb and TGAb of the thyroid diseases and analysis of their incidences and titer, our data strongly support that ELISA using purified TM and TG is a very useful and promising method for diagnosis and distinguishing autoimmune from non-autoimmune thyroid disease, and also can be employed in monitoring the development and studying the pathogenesis of the disease. We found that there is a negative correlation between TMAb titer and T3, T4 values (P<0.01) which has not been reported before in the literature. According to the result of the study, we suggest an immunological classification of thyroid diseases.

This paper reports that 300 HBsAg positives were distributed in 262 families. 14 of the 262 families had two or more HBsAg positives. In the 14 families, 7 showed the same subtype HBsAg, probably due to HBV infection from family source. Another 7 families showed HBsAg of different subtypes, definitely due to infections from the community.

Using ambulatory electrocardiography (AE), the spontaneous variability in 40 cases of chronic stable premature ventricular complexes (PVCs) was studied. The mean hourly PVC frequencies over 24 hours ranged 2-1 682. When analysing pooled data, there was significant variance between different monitoring periods and between patients as well. The most appropriate duration of AE recording was found to be 24 hours. The lower the mean hourly PVC frequencles, the bigger the coefficient of variation. Using linean regression analysis, the reduction of PVC frequency attributable to spontaneous variability with 95% confidence intervals ranged from 59 to 8l% being related to the number of hospitalization days. Clinically, to evaluate antiarrhythmic drug efficacy, one should assess the reduction in PVC frequency of spontaneous variability advance, and a greater reduction rate is required to be considered as true drug effect. The previous fixed standard for assessing an antiarrhythmic drug response is no longer advisable.

To develop a more comprehensive index for predicting the prognous of liver cirrhosis. 300 consecutive patients with cirrhosis were studied in terms of survival from 1975 t0 1986. Median follow-up period was 5.3 years. A multivariable survival analysis (Cox's regression model) using clinical biochemical data obtained at admission disclosed eight factors of value in predicting prognosis: age, frequency of previous GI bleeding, ascites, hepatic encephalopathy, serum albumin, serum bilirubin, hemoglobin and prothrombin time. A prognostic index was constructed for the calculation of the estimated survival probability.