1991年 · 第104卷第01期

It was demonstrated recently that a local renin-angiotensin system (RAS) exists in the heart and coronary vessels, and the angiotensin converting enzyme inhibitors can protect the heart from ischemia. Eight patients with NYHA class II-IV subjected to valve replacement were studied in protecting the heart from global ischemia with captopril during open heart surgery. After the ascending aorta was clamped, 500-1000 ml 4 ℃ modified St. Thomas No 1 cardioplegic solution containing 0.058-0.23 mmol/L captopril was perfused into coronary arteries under pressure until the electrocardiogram showed disappearance of myocardial electroactivity. The cardioplegic perfusion was repeated every 30 minutes thereafter during cardiopulmonary bypass (CPB). All the hearts rebeat after reperfusion either spontaneously or from defibrillation without any trouble. Three patients developed an A-V dissociation which returned to sinus rhythm or atrial fibrillation after a tiny dose of dopamine or isoprenaline intravenously. All the patients weaned from the CPB easily with a stable heart rate and a reasonable MAP. None of them needed inotropic support, even those with severe heart failure before operation did not either, and all recovered uneventfully.

272 cases of schistosomal egg induced polyps collected from mass-screening for colorectal carcinoma in Jiashan County were divided into 3 types: fibrous type (FT), mixed type (MT) and epithelial proliferative type (ET). The ET was characterized by crypt elongation, hypertrophy, variation in size, disorderly arrangement, as well as the high percentage of atypical hyperplasia (64.9%). The coexistence and transition between inflammatory reactive hyperplastic and neoplastic crypts were noticed. By HID/AB staining, sialomucins were increased in ET, CEA and PNA receptors detected by the ABC method were present in 18/20 and 6/18 of ET respectively. The mucin expression of ET was similar to that of adenomas. It is likely that a spectrum of ET, atypical hyperplasia and adenoma may exist. We suggest that the patients with ET, especially those with atypical hyperplasia, should be regarded as "risk group", and close follow-up is needed.

Nasal mucous membrane of patients with rhinitis medicamentosa caused by prolonged use of decongestants (privine) was studied by measurement of nasal mucus clearance time and observation of pathological changes under both optical and electron microscopes. It was found that privine destroyed the nasal cilia and mitochondria of epithelial cells, and disturbed their function so that they were damaged and dropped. Pathologically, the nasal epithelia were swollen, the arterioles dilated, and the glands proliferated. Twenty-two patients with rhinitis medicamentosa were treated by topical dexamethasone or triamcinolon in normal saline for 1-2 weeks followed by normal saline as regular nasal drops. Eight patients were treated effectively by oral ATP 20mg tid. The results were evaluated by nasal mucus clearance time measurement and rhinomanometry.

The administration of Li2CO3 to female LACA mice for three consecutive days before or after 4Gy whole body γ-irradiation appeared to have both preventive and therapeutic effects on radiation-induced leucopenia, especially on the depression of CFU-GM. It is effective in small dosage, short course, and even when given 24 hours after irradiation.

Twenty patients with various forms of lymphedema were studied by indirect lymphography. Isovist, a new non-ionic, water-soluble, dimeric contrast media, was used for intradermal infusion. Simultaneous indirect lymphography showed characteristic patterns of lymphatics. The initial lymphatics were visualized by intradermal infusion of the newly developed isovist. However, they were not opacified with direct lymphography unless in the presence of valvular insufficiency. No systemic side-effects were observed except for a feeling of discomfort at the injection site. The results showed that indirect lymphography with intradermal infusion of Isovist is useful for demonstrating dermal lymph vessels and for the diagnosis of lymphedema.

Salmonella typhi (S typhi) infected models were established to evaluate the latex agglutination test (LAT) and staphylococcal coagglutination test (SCT) for the detection of S typhi Vi antigen in blood and urine. Antigens in serum or urine were detected within 7 days after infection with positive cultures, and decreased in 2 weeks. LAT and SCT were positive in 7 mice with no bacteria isolation from blood and urine but their spleen aspirates yielded S typhi. Both tests are rapid and sensitive and may be used for the diagnosis of typhoid infection, especially in partially treated patients when their blood cultures are negative.

Clinically, 32 cases of intrahepatic cholestasis and 30 cases of severe chronic hepatitis with a bilirubin level higher than 171 μmol/L were studied. The results showed that bilirubin was 420 μmol/L in the first group, and 480 μmol/L in the second group (P>0.05); TXB2 was 306 pg/ml and 271 pg/ml (P>0.05) while PGF1α was 253 pg/ml and 494 pg/ml (P<0.05) respectively, both were higher than their normal values (P<0.01). The cases were divided into acute, moderate and severe types according to their pathological lesions. Experimentally, intra- and extrahepatic cholestasis and necrotic liver tissues were induced by ANIT, ligation of common bile duct, and carbon tetrachloride respectively. Bilirubin was 629 μmol/L, 124.8 μmol/L, and lower than 17.1 μmol/L (P<0.01); plasma TXB2 was 634 pg/ml, 1036 pg/ml, and 239 pg/ml (P<0.01); PGF1α was 186 pg/ml, 218 pg/ml, and 868 pg/ml (P<0.01) in the three groups respectively. No statistic difference was found in their TXB2 and PGF1α. Our studies suggested that plasma TXB2 and PGF1α in the liver was not related to the severity of liver lesions. TXB2 and PGF1α are positively correlated with the increase of bilirubin while TXB2 is negatively correlated with PGF1α, which might serve as an index for cholestasis, and be a cause for deepening jaundice.

It was shown by flow cytometry analysis that crystalized preparation of Cordyceps sinensis (Cs-Cr) caused significant elevation of the number of T helper cells and Lyt-1/Lyt-2 (T helper to T suppressor cell) ratio both in peripheral blood and the treated mice spleen. The spleen weight, phagocyte counts and phagocytic activity were also elevated in the treated group. In addition, Cs-Cr could protect T helper cells from the immunosuppressive effects of prednisolone acetate and cyclophosphamide. These results further substantiate the fact that Cs-Cr is an immunoregulator/biological response modifier of cellular immunity and may be potentially useful in handling immunodeficient or immunosuppressed patients.

When the leukemia cells in 14 patients with acute promyelocytic leukemia (APL) were induced by all-trans retinoic acid (RA) treatment, the activity of protein kinase C (PKC) increased with the differentiation. In the control cells, the activity of PKC was only 47±39.3 pmol.mg-1/min, while it was 149.3±150.1 pmol.mg-1/min after differentiation. There were 90.1±7.2% promyelocytes in the control group, and 8.9±5.6% in the induction group. Therefore, we think that there is a close correlation between PKC and the differentiation of promyelocytic leukemia cells.

Multilocular cystic renal cell carcinoma (MCRCC), and its pathological characteristics and roentgenological and B-mode ultrasonographic appearances are described. MCRCC, a special renal carcinoma, can be divided into localized and diffused forms.

An ovarian gynandroblastoma was found in a 59-year-old woman. The tumor consisting of mixed Sertoli-Leydig cells and granulosa-theca cells demonstrated no malignant features. Bisexual cells in gynandroblastoma derived from a common gonadal mesenchyme precursor or indifferent cell. The excision of appendages with tumor or hysterectomy was sufficient.