1993年 · 第106卷第09期

Ninety-one patients with spinal injuries were studied by CT scanning. A comprehensive classification of spinal injuries was proposed according to the mechanism of trauma, the concept of three-column anatomical structure of the spine and the degree of spinal canal stenosis. CT scanning was advantageous in the diagnosis of spinal injuries such as clear detection of the three-column anatomical structure of the spine and spinal canal, demonstration of fracture lines in all 3 planes, determination of the amount of displacement of bony fragment into the spinal canal, assessment of spinal stability or instability, and restricted movement of the patient. The key points in general CT diagnosis, its role and limitation in the diagnosis of spinal injuries were discussed. The authors conclude that combined comprehensive classification of spine injuries is helpful in planning suitable treatment for the patient and predicting prognosis.

102 patients with nasal polyps receiving ND: YAG laser surgery or routine surgery were followed up for 18-36 months. The postoperative recurrence rates were 40.6% (24/54) and 66.6% (32/48) respectively for the patients of the two groups. Laser surgery is marked by less bleeding, no postoperative packing of the nose and lower postoperative recurrence rate, and it seems to be better than routine removal in the treatment of nasal polyps.

Neutrophils (PMN) from 20 patients with atopic disease (atopy), the parents of 8 of the patients and 10 normal controls were studied by light-microscopic cytochemistry. The results revealed that myeloperoxidase (MPO) and acid phosphatase (ACP) activities in PMN in all cases significantly decreased and alkaline phosphatase activity was normal. Parents or parent of 7 of those patients had PMN enzyme deficiency similar to that of the patients. The results indicated that a primary combined and partial deficiency of MPO and ACP in PMN azurophilic granule existed in atopy. It is postulated that the deficiency led to reduction of PMN bactericidal power and delay of bactericidal action. Foreign bodies which were partially degraded could possess antigenic property. This is believed to be the important cytobiological mechanism of the tendency toward infections and formation of sensitive antigen in atopy.

The distribution and histochemical characteristics of mast cells in the stroma of cervical squamous cell carcinoma were investigated using different staining methods of alcian blue-safranin, berberine sulphate and toluidine blue. The findings suggest that mast cells in the stroma of the squamous cell carcinoma of the cervix might contain a glycosaminoglycan different from that of typical connective tissue mast cell (CTMC) and mucosal mast cell (MCC). They thus, might be a specific subset of mast cells though sharing some of the staining properties of both CTMC and MMC. In the cervical carcinoma in situ, mast cells were distributed closely around the tumor or the involved glands with great density and the number was significantly higher than that of the invasive carcinoma (P<0.01). In invasive carcinoma, mast cells were mainly distributed in the deep stroma and the stroma around the tumor, only a few in the stroma within the tumor (P<0.01). The significance of mast cell reaction in the stroma of squamous cell carcinoma of the cervix is discussed.

The histomorphologic changes of the mammillary bodies (MB) in 31 patients and 8 spontaneously hypertensive rats with brain hemorrhage were studied by light and electron microscopy. The results showed that the frequency of the ischemic change neurons in medial nucleus in MB is much higher than that in hippocampal CA1 section and multiplicated double-deck or multistratum basal lamina formed a network or branch pattern, which indicate that MB may be of important function.

Spontaneous release of IgG, production of IgG, IgM and IgG subclasses induced by PWM in vitro, serum IgG, IgM, IgA and IgG subclasses were measured in 23 patients with acute Kawasaki disease (KD). The results showed that there was polyclonal B cell activation with significantly increased IgG1 and IgG3. As compared with 21 healthy controls, the mean activities of B cell growth factors (BCGFs), B cell differentiation factors (BCDFs) and interleukin 6 (IL-6) were significantly elevated. IL-6 activity was correlated with the production of IgG, IgG1, IgG3 and IgM, while BCGFs and BCDFs were also correlated with IgG1. The serum level of circulating tumor necrosis factor (TNF) determined in 16 patients with acute KD using double antibody ELISA was 1.86-8.83 μg/ml, but it was less than 1 μg/L in normal controls. The clinical value of increased TNF in serum is discussed.

Cigarette smoking-induced circulatory crisis occurred in two patients receiving toe transfer and one patient having musculocutaneous flap. After anticoagulation and antispasm treatment, one survived and two failed. Experimental studies demonstrated that cigarette smoking is harmful to the healing of endothelia at the anastomotic site of vessels. Five days after operation, the complete recovery rate of the endothelium over sutures of anastomotic sites was 16%-19% in smoking groups, but 75% in the control group. The mechanism and characteristics of circulatory crisis caused by cigarette smoking are discussed.

Smooth muscle fibers are considered very important in penile erection and relaxation. The reduction of intracavernosus smooth muscle fibers can provoke impotence. The percentage of smooth muscle fibers in corpus cavernosum specimens was studied quantitatively in normal men and impotence patients by means of computerized image analysis. The percentage of smooth muscle fibers in the specimens of 14 normal men, ranged from 41% to 61% (average 50%) and in 12 impotence patients, it was 22% to 46% (average 31%). A decrease of smooth muscle fibers and an increase of collagen fibers were noted in impotence patients.

Infection is a leading cause of death of renal transplantation and how to control it is still an urgent problem to be solved. Bacteria culture, computerized modified McGuckin's monitoring methods, OKT monoclonal antibody technique and radioimmunoassay (RIA) were used on studying the cause, monitoring and prevention of the infection. Results showed that 22 out of 24 cases (91.7%) were colonized by Gram-negative bacilli in pharynx and groin region. Of them, 15 were infected with the same bacteria in wound, urine, blood and lung. Six out of 7 cases with serious infection were colonized by Gram-negative bacilli on the surface of the whole body. The computerized modified McGuckin's method predicted and analyzed the infection outbreak much more fast and accurate, with a rate of over 80%. Helper/suppressor lymphocyte ratio of 1.08 was taken as a threshold value for the diagnosis of infection. The results suggested that the change of skin flora is closely related with the infection. Monitoring the alteration of skin flora is an effective method for the prevention and control of severe infection. The pharynx and groin regions of the patients are stable reservoirs of Gram-negative bacilli which may cause infection easily. Computerized quantitative analysis may increase the efficiency and accuracy of infection surveillance. In order to preserve the immune system as much as possible and prevent rejection of transplant graft, proper use of immunosuppressive drugs and regulation of the immune system of the patients are the key for preventing infection.

One hundred and eight patients with spasticity of the paralytic limbs were treated successfully with hyperselective posterior rhizotomy (SPR). Of the 108 patients, 100 had cerebral palsy, 2 hemiplegia, 3 sequelae of cerebral injury, 2 paraplegia and 1 multiple sclerosis. Twelve patients received cervical SPR and 96 lumbosacral SPR. Laminectomy is performed to open the dura and to separate the posterior spinal root into several rootlets. The lower threshold rootlets were divided after electrical stimulation. Follow-up for 6 to 30 months showed that the effective rate of reducing spasticity was over 95% and functional improvement rate over 80%.