1991年 · 第104卷第06期

During total hip replacement for 12 cases of advanced osteoarthritis of the hip joint in aged women, three types of diseased or abnormal articular cartilage with different degrees of severity (white articular cartilage, white and hyperplastic articular cartilage, and yellowish articular cartilage) and ivory bone were obtained together with their subchondral bone tissues. These specimens were processed and studied under scanning electron microscope and were compared with sex- and age-matched non-osteoarthritic femoral head articular cartilage specimens. The following findings were observed: 1. In non-osteoarthritic femoral head, the subchondral bone plate was quite thin. The bone plate connected on its deep surface with the lattice-work of trabeculae of the epiphyseal region. The trabeculae were fine and smooth and some revealed round or spindle-shaped callus resulted from microfracture. 2. In osteoarthritic femoral heads, with increased the severity of the articular lesion, the articular cartilage gradually became thinned out and eventually lost. The subchondral bone plate was markedly thickened. The epiphyseal trabeculae were also thickened and turned rough so that the lattice-work pattern gradually disappeared. The thickened trabeculae finally fused into a large piece of dense bone tissue. No microfracture was detected. These changes were attributable to the increased stress imposed on the subchondral bone tissues as a result of defective articular cartilage. Consequently, the changes on the part of the subchondral bone tissues of the osteoarthritic femoral heads were the sequent, rather than the cause, of the articular lesions.

To analyze the effects of flexion-extension motion of lumbar spine on the position and shape of lumbosacral dural sac, 10 flexion/extension lateral myelograms of cadaver specimens of normal lumbar spine were measured. The results showed that moving from flexion to extension both sagittal diameter and length of the dural sac decreased significantly, the dural sac moved caudally, and the sagittal diameter of the anterior epidural space decreased in the mid-vertebral level but increased in the intervertebral level. The dynamic changes of the dural sac and their influence factors and clinical relevance were discussed.

An epidemic of parenterally transmitted non-A, non-B hepatitis (PT-NANBH) occurred in plasmapheresis donors in Guan County, Hebei Province, China, in 1985. PT-NANBH was diagnosed by epidemiological studies and serological exclusion of HAV, HBV, CMV and EBV infections. Recently, 163 sera samples of 108 patients with PT-NANBH and 65 sera samples of 49 cases with elevated alanine aminotransferase (ALT) levels collected during the epidemic were tested by anti-HCV EIA (Chiron C100). The positive rates of anti-HCV in these two groups were 89.8% (97/108) and 93.9% (46/49), averaging 90.8%. The figures increased with the course of illness and persistance of ALT elevation, i.e., 17.6% and 55.6% within 1 month, 88.9% and 87.5% at 6 months and 100% and 100% after 2 years. Five patients with PT-NANBH and 1 with elevated ALT levels were followed up for 3 to 4 years. We demonstrated that anti-HCV remained positive after the disease had resolved and ALT levels had normalized.

Five hundred and twelve boys, aged from 5 months to 12 years, with phimosis were treated by application of a specially designed balloon catheter (patented). 1% dicaine topical anesthesia was used. 3-6 months follow-up showed that all the patients were cured. The procedure is simple, safe and much less traumatizing than the conventional circumcision. The mechanisms of balloon dilation, the age-specificity and the anesthesia were discussed.

Eight patients with Addison's disease or Cushing's syndrome received adrenal homograft for 9 times after total adrenalectomy. All patients were followed up for 1 to 5 years. Symptoms and signs were improved without the supplement of steroids. The grafts showed satisfactory endocrinal functions in the recipients, but the grafts were dead in two patients 2 and 4 years after operation respectively. One of the two patients received the second homograft with good result. Single perfusion and ice-storage method of the all-adrenal gland and their clinical results were also presented.

There is evidence that the cholinergic system positively modulates growth hormone (GH) secretion. In the present study, we observed the effects of cholinergic enhancement by pyridostigmine (PD), a cholinesterases inhibitor, on GH release in both normal (n = 13) and GH deficient children and adolescents (n = 10). Responses of GH to insulin hypoglycemia (Ins) were also observed. In the normal subjects, PD-induced serum GH peak level was significantly higher than that induced by Ins (P less than 0.01), while the GH level in the patients with pituitary dwarfism showed no increase in both tests. This study indicates that PD test may be considered a sensitive dynamic test in evaluating pituitary function of GH secretion in children and adolescents.

The purpose of this experiment is to study the role of arginine vasopressin (AVP) in acute cerebral ischemic edema in Mongolian gerbils. The results show that intracerebroventricular injection (ICV) of AVP exacerbates acute ischemic brain edema, while ICV of AVP antiserum significantly decreases the ischemic brain edema. Nimodipine (calcium antagonist) cannot block this role of AVP in brain edema. In addition, the cortical Na+-K+ ATPase activity is significantly decreased, while the cAMP content of ischemic cortex and hypothalamus and the cGMP content of the hypothalamus are markedly increased after AVP ICV. These suggest that AVP may play an important role in the pathophysiologic process of ischemic brain edema by inhibiting the Na+-K+ ATPase activity of the cerebral cell membrane and the AVP receptors mediated by cAMP and cGMP.

Small intestinal mucosal morphology, lactase activity and lactose hydrolysis were examined by peroral intestinal biopsy and intraluminal perfusion of the small intestine in 28 patients with acute and chronic diarrhea. This study shows that lactase deficiency and mucosal damage are more common in childhood diarrhea, and there are positive correlations among intestinal morphology, lactase activity and lactose hydrolysis. A small bowel biopsy is useful both in establishing the diagnosis and guiding dietary treatment for infants with chronic diarrhea. The pathophysiologic mechanism of diarrhea is also discussed.

The concentration of human serum superoxide dismutase-1 (hSOD-1) containing copper and zinc ions were measured by radioimmunoassay healthy nonpregnant women, 15 normal pregnant women, 15 patients with mild to moderate hypertension (MMHSP) and 15 with severe hypertensive syndrome of pregnancy (SHSP). The mean serum hSOD-1 concentration in nonpregnant women was 148.84±60.53 (x±s) μg/L; while in the other 3 groups it was 394.19±122.21 μg/L, 377.12±173.45 μg/L and 581.15±118.50 μg/L. The results suggest that harmful free radicals increase gradually and a strong body defence system against oxidation damage of tissue cells is produced in the course of normal pregnancy and MMHSP. With cardionatrin treatment serum hSOD-1 concentrations of patients ameliorated returned to the level of normal pregnancy. The results indicate that there is a positive correlation between cardionatrin and hSOD-1 levels (r = 0.569, P less than 0.05), and a physiological regulation of the defence system exists, which may be related to the white blood cells. Hence, hSOD-1 probably plays a significant role in defence during normal pregnancy and hypertensive syndrome of pregnancy (HSP).

Nine tumor-associated antigens (MG7-, MGdl-, MC3-corresponding antigens, CEA, P21ras, Sialoglycoprotein, CA 19-9-like, Sialo-Tn and Lea-like antigens) were investigated on biopsy specimens of different types of intestinal metaplasia (types I, II and III) taken from 112 patients with benign gastric conditions. The incidence of positive staining for 9 antigens except for P21ras in type III intestinal metaplasia was significantly higher than that in types I and II (P less than 0.05-0.01). These 112 patients were clinicoendoscopically followed up for 15-70 months. Five of them were found to develop gastric carcinomas within 25-60 months, giving a cancer detection rate of 4.5%. They were detected from type III (16.1%) patients, but none was found in patients of types I and II, and the differences were significant (P less than 0.05-0.01). Our results indicate that type III intestinal metaplasia has a higher potentiality in developing malignancy and that MG7, MGd1, MC3, CEA, CA19-9-like and Sialo-Tn antigens are valuable tumor markers in defining the high-risk group of gastric carcinoma.

Using α-32P-dCTP labelled human papillomavirus type 16 DNA genome probe (cHPV 16 DNA, cloned and identified from a Chinese cervical invasive carcinoma), 3 HPV 16 genomic relative sequences were detected in 6 biopsies of laryngeal carcinoma. The results showed serious HPV infection in laryngeal carcinoma. This indicates that HPV infection may play an important pathogenetic role in cancer development.

Immunohistochemical and ultrastructural findings in a primary intracranial endodermal sinus tumor are reported in this paper. The tumor cells exhibited AFP, CEA and anti-alpha-1-trypsin positive immunoreactivity immunocytochemically. Aggregates of electron-dense material in the extra- and intracellular spaces and amorphous basement membrane-like substance were seen extracellularly by electron microscopy. The clinicopathological, immunocytochemical and ultrastructural features were consistent with the criteria for primary intracranial sinus tumor.

Filariasis control including a preparatory phase in the early 50s and two more extensive campaigns in the late 50s and 70s, has gained remarkable achievements. By the end of 1987, filariasis in 781 (90.4%) of 864 counties/cities was brought under control, i.e., the microfilariasis rate declined to less than 1% in the whole population in every village concerned. At present, there remain about 2,446,000 filariasis cases, accounting for 7.9% of 30,099,400 before nationwide campaigns. Microfilaria carriers among the remaining cases amounted to 1,473,000 and amicrofilaremic but symptomatic, to 973,000. The major experience comprises the integration of the control project into national health program, the mobilization of various sectors, including the community, the investigators and technical personnel in research institutions and control services all to participate and cooperate in problems and difficulties encountered.

It is generally believed that epidural blocks are most widely used in China. However, there is yet no substantial study in this respect. A nation-wide survey appears to be necessary. Questionnaires were sent to 237 hospitals located in 6 geographically wide-scattered areas and to some military hospitals as well. 90 answers were obtained with complete data necessary for this survey. There are 1,304,214 administrations of epidural blocks documented in these 90 hospitals. Of which 38.8% are lumbar, 32% lower thoracic, 23% middle thoracic, 4.6% upper thoracic and 1.6% cervical blocks. These data showed that operations from the neck down to the lower extremities were performed under epidural block without discrimination of puncture location. 98.33% of the blocks were satisfactory to meet the need of operations. Persisting paresthesia occurred in 0.013% of these cases. The incidence of accidental puncture of dura was 0.32%. About 2/3 of these dura punctured cases received 1-4 times of repuncture. No correlation was found between repuncture and development of total spinal anesthesia. Among the complications, incidence of respiratory depression was 0.54%. However, only 5% of these depressed cases needed intubation and artificial ventilation. No signs of dura puncture were noticed, but subarachnoid block did appear in 0.04 of cases. Incidence of total spinal anesthesia was 0.013%. Not all, but a little more than half (54.6%) of the total spinal cases needed intubation and artificial ventilation. Incidence of paraplegia was 0.001% and 2 out of 3 of these cases were recovered. The anesthetic mortality rate was 0.0012%. Respiratory depression was the major cause of death. It is concluded from this study that epidural block is widely used in China due to its satisfactory anesthetic effect, less complication and lower morbidity and mortality.