1994年 · 第107卷第01期

Thirty-two patients with spinally originated muscle spasticity were treated with a transcutaneous electrical nerve stimulator, the Han's acupoint nerve stimulator (HANS) via skin electrodes placed over the acupoints on the hand and leg. High frequency (100 Hz), but not the low frequency (2 Hz), stimulation was effective in ameliorating muscle spasticity. While the therapeutic effect lasted for only 10 minutes in the first treatment, it became consolidated after consecutive daily treatment for 3 months. The anti-spastic effect induced by high frequency electrical stimulation can be partially reversed by a high dose of naloxone. The results suggest that the anti-spastic effect elicited by peripheral electrical stimulation is mediated, at least in part, by the endogenous opioid ligand interacting with the kappa opiate receptors, most probably dynorphin, in the central nervous system.

Postoperative reflux esophagitis is a common complication after partial removal of the esophagus and the whole gastric cardia for reconstruction through esophagogastrostomy. In 10 cases, the lower esophageal sphincter (LES) was preserved for a length of 2.05±0.33cm (mean±S) during partial esophagectomy for benign or malignant lesion at the middle and lower portion of the thoracic esophagus. The mean value of the LES pressures measured two weeks after operations was 2.40±0.64 kPa (18±4.8 mmHg) and the postoperative X-ray barium meal examination revealed no evidence of gastroesophageal reflux. Our study suggested that the preserved LES should effectively act as a functional barrier against the development of reflux esophagitis.

The distribution and location of atrial natriuretic peptides (ANP) in the cochlear stria vascularis of normal guinea pigs were studied to find out regional regulation factors of cochlear blood flow (CBF) and productive foundation of cochlear endolymph by ABC immunocytochemistry and immunoelectromicroscopy. The ANP-IR products were seen in the stria vascularis of the 1-4 turns of the lateral wall of the cochlear, more markedly along its margin; and were negative in the spiral ligaments. Immunoelectronmicroscopically, a plenty of sphericals of 250-350 nm in diameter were noted in the cytoplasm of marginal and intermediate cells, but few in the basal cells. The results suggest that the cochlear stria vascularis had the function of secreting ANP in the guinea pig.

Adult polycystic kidney disease was diagnosed with pedigree analysis using polymorphic DNA markers linked to the disease gene in 5 families. The markers were thoroughly characterized in the population. We noted two important markers, 3'HVR and 24-1, which flank the disease gene PKD1 in normal Chinese. Southern hybridization was used, and numerous 3'HVR/PvuII polymorphic allelic bands varied from 1.4 kb to 8.0 kb with a positive skew distribution. They were divided into 11 groups with an interval of 0.6 kb and a heterozygosity rate of 0.86. Allele frequencies were observed. When the probe 24-1 was hybridized with genomic DNA digested by TaqI, two alleles, B1 and B2, were detected with frequencies of 0.76 and 0.24, respectively. B1 was 3.8 kb in size and B2 was composed of 2 bands, 1.5 kb and 1.3 kb. The polymorphism information content was found to be 0.297. Using these two markers for linkage analyses of 5 affected families, we confirmed the linkage between 3'HVR and the disease gene PKD1 and made presymptomatic diagnosis of the members at risk.

From 1978 to 1988, 14 giant intracranial aneurysms (more than 2.4 cm in diameter) and one large aneurysm (1.5 cm in diameter) were treated by extracranial/intracranial (EC/IC) bypass or cerebral artery reconstruction. Of the aneurysms, 10 were located at the intracavernous carotid artery (CCA). One of the 10 aneurysms was posttraumatic and located at both the carotid-ophthalmic artery segment and the bifurcation of the internal carotid artery (ICA). Three were seen at the middle cerebral artery (MCA) trunk. The aneurysms were demonstrated by angiography and CT scanning. They were treated with trapping of the aneurysm and superficial temporal artery (STA)/middle cerebral artery (STA-MCA) bypass with/without a graft (6 cases), cervical ICA ligation and STA-MCA bypass with/without a graft (6) aneurysm excision with an end-to-end anastomosis of the MCA and a STA-MCA bypass with a graft (1), proximal MCA occlusion and STA-MCA bypass with a graft (1), and aneurysm neck clipping following a STA-MCA bypass with a graft (1). The patients showed marked improvement after operation except one whose neurological deficit was aggravated temporarily. Postoperative angiography revealed that the anastomoses were patent in all cases. No surgical mortality or any delayed ischemic complications were noted after follow-up for 5.6 years. We believe that cerebral artery reconstruction or EC/IC bypass is still effective in the treatment of large and giant intracranial aneurysms.

Myoglobin, myosin creatine kinase MM (CK-MM), creatine kinase BB(CK-BB) in cardiac muscle and H chain of myosin in atrial and ventricular muscle were studied in specimens from 8 patients who died of sudden nocturnal death syndrome (SNDS) by avidin-biotin complex (ABC) method to investigate the possible early or very early myocardial ischemia in the syndrome. Hematoxylin-eosin staining was conducted for comparison. The results showed evident loss of CK-MM, CK-BB, myoglobin and myosin from cardiac muscle cells, indicating that occurrence of SNDS is closely associated with acute myocardial ischemia.

Two polymorphic sites of apolipoprotein B (apoB) gene, XbaI and EcoRI, were examined in 80 patients with documented coronary heart disease (CHD) and 60 healthy individuals selected from a population of Chinese Han nationality. Allele frequencies at these sites were compared between the patients and controls and their impact on lipid metabolism was also investigated. The frequency of X+ allele (presence of XbaI cutting site) in CHD patients was 0.10, which was significantly higher than 0.01 in controls (P<0.001). The same trend was detected for frequency of E-allele (lack of EcoRI cutting site) when it was compared between CHD patients and controls (0.11 vs 0.05), the difference was not statistically significant (P<0.1,>0.05). There was no relationship between XbaI RFLP and EcoRI RFLP. In the CHD patients, X+ allele was associated with the lower levels of HDL-C and apoAI when compared with X- allele, while no associations were found of X+ allele with other lipid parameters. On the contrary, the EcoRI polymorphism had no significant influence on plasma lipid and lipoprotein levels. Therefore, it was suggested that genetic variation at XbaI site of apoB gene might contribute to the determination of plasma HDL-C level and development of CHD in people among Chinese Han nationality.

Homogenates prepared from S. japonicum adult worms of different isolates from Anhui, Hubei, Guangxi, Yunnan and Sichuan Provinces were analyzed by SDS-PAGE and enzyme linked immunoelectrotransfer blot (EITB) tested with rabbit anti-snails antibody. The results of SDS-PAGE indicated that with silver staining both male and female worms of Guangxi isolate showed some definite differences in their protein profile, namely, absence of one band between 50-75 kDa in male worms and marked reduction in quantity of>110 and 30 kDa bands in female worms. There was no obvious difference among other isolates both in male and female worms. The EITB patterns were similar in S. japonicum of Anhui and Hubei, and it was also the case with isolates from Yunnan and Sichuan, except that Yunnan female worms had a distinct band at 84 kDa which could hardly be seen in EITB pattern of Sichuan female worms; female worms of Guangxi isolates also showed a distinct 84 kDa band. The EITB pattern of male worms from Guangxi isolates showed 2 main bands of MW>130 kDa against anti-Anhui snail antiserum which corresponded with the result of male worms of Anhui isolates. But these bands could not be seen with male worms from isolates of Yunnan and Sichuan.

Six patients with 95% to 100% occluded atherosclerotic lesions underwent percutaneous transluminal excimer laser coronary angioplasty (PTELCA). Among them, 5 were male and 1 was female; their age ranged from 28 to 66 years. Four patients had LAD stenosis and 2 LCX lesions. Acute angiographic and clinical success was achieved in all patients but one, with a success rate of 83.3%. It was demonstrated that PTELCA is a safe and effective therapy for selected patients with coronary artery disease.

The immunophenotype, rearrangements of T cell receptor (TCR) γ and δ chain genes as well as the immunoglobulin heavy chain (IgH) gene were studied in 37 cases of morphologically defined acute lymphoblastic leukemia (ALL). According to the expression of differentiation antigens, 8 cases were classified as T-ALL, 26 B lineage ALL, 2 acute undifferentiated leukemia (AUL) and myeloid phenotype. An order of TCR gene rearrangements was observed in T-ALL, with the rearrangement of δ gene preceding that of γ gene. Both genes were also found frequently rearranged and/or deleted in high proportions of the ALL of B cell lineage. However, the patterns of gene rearrangements were somewhat different between the T and B lineage ALLs. In contrast, the IgH gene rearrangements were observed only in the B lineage ALL. The immunogenotype analysis of ALL proved to be a useful marker of the clonality and provided us with important information on early human lymphoid differentiation. We conclude that the determination of TCR γ gene V-J junctional sequence can be used as clonal marker for detecting the minimal residual disease during clinical remission.

Since the early 1980s, China has confronting a dramatic change in population structure as well as a rapid aging process. The proportion of the elderly has been increasing nation wide, and dementia is becoming a major public health problem.

With the development of modern ophthalmology in the past 40 years, great progress has been made in visual electrophysiology in terms of clinical application, basic research and academic exchange in China. A series of visual electrophysiological measurements, such as electroretinography (ERG), evoked early response (ERP), electrooculography (EOG), visual evoked potential (VEP), which are assisted with various stimuli and computer analysis, have been used in testing different layers of the visual system. Some new relevant techniques have been developed and the academic organizations established. These demonstrate that clinical visual physiology has entered a new period of development.