1991年 · 第104卷第05期

A strain of fungus (CZ408) was isolated from white piedra of a female child. Mycological identification showed that it is the first case in the world. Asymptomatic white nodules were noted on the hair of the scalp, and they were distributed irregularly along the shaft 4-10 cm from the scalp. The nodules, hard, not easily broken or removed, consist of hyphae, spores and metabolic materials around the hair. Oral antimycotic drugs are effective in treating this disease.

24 specimens of nasopharyngeal precancerous lesions (NPP) were studied for stromal microvasculature by light microscope and image analysis for quantitation. FVIIIR: Ag was used as a vascular endothelium marker to show the blood vessels by immunohistochemistry. The microscopic and quantitative results showed that most cases had abnormal hyperplastic features similar to the stromal neovascularization of nasopharyngeal carcinoma (NPC). These findings suggest that abnormal hyperplastic vessels may be a prerequisite to cancerous transformation of nasopharyngeal epithelium.

This paper is a summary of our observations on 105 cases of infantile spasms. The age of onset was around six months after birth, but the patients came for treatment mainly about one year after onset. Fever of unknown cause, asphyxia, birth injury, infection of the central nervous system, tuberous sclerosis, phenylketonuria and recent immunization etc. were complained. Clinically, it is characterized by head nodding, mental retardation, myoclonic jerks and various neurologic deficits. EEG findings showed classical or modified arrythmia or other epileptiform patterns. About one third of 22 cases examined had abnormal brain stem auditory evoked potentials. Among 42 patients who underwent CT scanning before ACTH treatment, 18 were normal and 7 abnormal; during ACTH treatment 3 normal and 4 abnormal; after completion of treatment, 4 normal and 6 abnormal, suggesting no further atrophy of the brain. Examination of trace elements of the hair by particle-induced X-ray emission (PIXE) method in 23 patients revealed a significant difference in lead, calcium and zinc contents between patients and 101 controls, but no statistical difference in iron and copper contents between the two groups. Sodium valproate, prednisone and ACTH appear to be effective in the treatment of infantile spasms. Eight patients fully recovered, and they can go to school without difficulty. Many patients derived various degrees of improvement to the satisfaction of their parents. Two patients were still amented and often attacked by myoclonus. The effects, side effects of these drugs, and the possible pathogenesis were discussed.

Fourteen cervical spondylitic myelopathy (CSM) patients were clinically diagnosed and proved by MRI and surgery. The results of 11 patients showed that 8 (72.7%) had motor evoked potential (MEP) abnormality with prolongation of central motor conduction time (CMCT) in 7, and absence of motor action potentials after C7 stimulation in one. Five of the 11 patients showed normal somatosensory evoked potentials (SEPs) along the same arm. The short term (2-4 weeks) follow-up study in 10 patients showed normalization of the prolonged CMCT in one and reappearance of MEPs with C7 stimulation in another. Non-invasive and painless magnetic transcranial stimulation of the motor pathways is useful in the assessment and management of CSM patients, and is better than electrical stimulation.

A cross-section study was carried out to assess the general patterns in use of antimicrobial agents and the trends of bacterial resistance in Huashan Hospital. Of 2,400 patients whose charts were reviewed, 61% were given such drugs. 3,596 antibiotic courses were prescribed. Gentamicin was most frequently used. Results of the susceptibility test of 320 bacterial strains showed a high percentage of resistance against gentamicin, ampicillin, and chloramphenicol. Our findings suggest that antibiotic policies in the hospital need reappraising.

This paper reports the study of the effect of ginsenopolypeptide on 3H-TdR integration in normal human blood lymphocytes in vitro with micro-blood culture method of 3H-TdR integration. The results showed that the effect of ginsenopolypeptide on 3H-TdR integration in normal human peripheral blood lymphocytes which can be activated by phytoagglutinin was enhanced at low dosage and inhibited at high dosage, and its stimulating spike was 10-6 μg/ml (P less than 0.01).

It has been reported that Ginsenoside can increase body resistance to many harmful factors and protect tissues from damage when an organism is in stress. To understand the mechanism of this action, a study on the antioxidative effect of Ginsenoside Rb1 and Rg1 was carried out. Results showed that Ginsenoside Rb1 and Rg1 could inhibit lipid peroxidation of rat liver and brain microsomes and that Rb1, at the final concentration of 10-4-10-3 mol/L, could scavenge O2-. induced by liver microsome-NADPH-gossypol system. In in vivo experiment, Rb1, at a dose of 50 and 25 mg/kg/day × 3 ip, inhibited MDA formation in liver homogenate of rats by 26.8% (P less than 0.05) and increased the activities of catalase and GSH peroxidase by 47.2% (P less than 0.001) and 96.4% (P less than 0.001), respectively. However, no change in the activity of superoxide dismutase was found in liver cytosol of rats treated with Rb1.

Thirty cases of chyluria were treated by means of lymphonodovenous anastomoses according to the principles of lymphovenous shunt. A conical tissue of lymph node close to the greater saphenous vein in the inguinal region was removed and the remaining tunnel-shaped node was anastomosed to the vein to drain the lymph into the venous system. Twenty-one cases were followed up for six months after the operation. Among them, 16 (76.2%) showed disappearance of chyluria, and 2 (9.5%) were improved, giving an effective rate of 85.7%. This operation avoids damage to both the afferent and efferent lymphatic vessels, and affords a large anastomotic stoma for free passage of the lymph into the vein.

From January 1986 to June 1989, the CT-guided stereotactic evacuation was performed in 38 cases of hypertensive intracerebral hematoma with satisfactory result. 24 patients were male and 14 female. The age ranged from 37 to 78 years, with an average of 55. 24 cases had their hematoma in internal capsule, 7 in cerebellum, 5 in subcortex, and 2 in brain stem. The interval between the occurrence of hemorrhage and evacuation of hematoma was 24 hours or less in 18 cases, 2-3 days in 14 and 4-7 days in 6. The volume of hematoma was estimated by CT scanning being more than 100 ml in 6 cases whereas much less in 2 cases of the brain stem.

To provide a more effective treatment and improve the outcome of surgical treatment of lumbar intervertebral disc protrusion, the values of lumbar intervertebral disc prosthesis (LIDP) were investigated. LIDP was specially designed and made of silicone rubber. The properties of material mechanics were investigated by compressive test and damage test of LIDP specimens. The biocompatibilities of LIDP were observed experimentally in monkeys. The surgical applicabilities were studied by in vitro experiments of fresh human lumbar spine. The results showed that LIDP has the advantages of good biomechanical applicability, biocompatibility and surgical applicability. LIDP is able to maintain the intervertebral space, stress balance and stability of the lumbar spine. after lumbar intervertebral disc excision, the replacement of LIDP could restore the functions of the lumbar spine and improve the curative results of disc excision.

A case of hypothalamic encephalitis proved by postmortem examination is reported. The patient was a three-year-old Chinese boy who had complained of obesity for one year and fever for half a year. Three days after admission to a hospital, the patient suddenly died of allergic reaction to intramuscular penicillin, without additional complaints. Autopsy revealed severe bilateral outfall of neurons in the ventromedian hypothalamic nuclei with diffuse hyperplasia of astrocytes and some glial nodules consisting chiefly of oligodendroglias and perivascular cuffing. Similar changes were noticed in hypothalamus at the level of optic chiasm, but the posterior hypothalamic nuclei and lateral hypothalamic nuclei were intact. This article provides significant data for the study of hypothalamic function.

The first case of cheiloplasty recorded was in China at about 200 BC. The technique of course has been vastly improved over the centuries. Cleft lip and/or cleft palate are among the most common congenital anomalies in China and the world. There is controversy over some of the surgical techniques used and age for operation, especially in cleft palate, but the condition requires surgery. Unilateral cleft lip is operated on at 3-6 month of age and bilateral cleft lip at 6-12 month of age. Views on palatoplasty are: 1. Cleft palate should be repaired at an early age; 2. Supplementary orthodontic treatment to expand the upper arch postoperatively is necessary, and orthognathic surgery is performed if needed when the patient has matured. This is the best choice at present.