1994年 · 第107卷第04期

Of 42 patients undergoing a microvascular decompression for trigeminal neuralgia with a follow-up of 4 to 7 years, 32 (76.19%) had no postoperative recurrence of neuralgic pain, 4 (9.52%) had a minor recurrence and 6 (14.29%) had a major recurrence. It was considered that the neuralgic recurrence might be due to some possibly missed pathogenic vessel during operation or a new compression of the trigeminal nerve root occurring after operation.

Ninety cases of unstable fracture of thoracolumbar spine treated with a modified Roy-Camille type of pedicle screw plating are reported. They were followed up for an average of 2 years and 5 months. Comparing the pre- and postoperative X-ray films for the angles of kyphosis, degrees of compression of anterior vertebral height and degrees of displacement, the results were quite satisfactory. A complete reduction was obtained in 74% of the unstable fractures at the levels between the T11 and L3 vertebrae. This kind of internal fixation has been proved to be strong and safe allowing for early mobilization with few complications. The operative technique is described and the causes of complication are analyzed.

From May 1987 to January 1993, 233 patients with achalasia admitted to our hospital had been treated using a self-invented soft (fibrous) esophageal dilator, including 16 patients who failed in Heller's myotomy. 228 (97.85%) patients were dilated by way of mouth, 3 (1.29%) by way of stomach and 2 (0.86%) had had a transthoracic operation because of the rupture of the esophagus due to dilation. 19 (8.15%) came back to have the second dilation and 2 the third dilation. 73 (31.33%) cases were dilated in the out-patient department. In 97.85% of the patients, excellent and good results were obtained, through once, twice or thrice of dilation by way of mouth. No esophageal reflux or any sequela was seen after dilation.

In clinical and anatomical studies carried out during 1986-1990, two new findings were identified: a small spade-shaped myocutaneous tag which can often be found at the medial side of the cleft near the columella base and the levator septi nasi muscle which draws the cleft side of the philtrum upwards. With the full use of the two findings, a method of unilateral cleft lip repair without making incisions on the lip surface was developed. Since 1986, 52 cases of unilateral cleft lip have been repaired with this method. The early and late results were gratifying.

The effect of 806 microstimulations were observed in 16 patients with movement disorders, dystonia (DA, n=6) and tremor (TR, n=10). Among the 347 sites in DA patients motor response was seen at 29 sites, the response with increased dystonia was seen at 28 sites. The effect could be seen at 14 sites (50%) in ventrointermedialis (Vim), five sites (18%) in ventrocaudalis (Vc) and five sites (18%) in white matter (Wm). As for the other four sites, one site was in ventraloralis anterior (Voa), two sites in ventraloralis posterior (Vop), and one site in dorsal thalamus (dth), but reduction of dystonia drive was only seen at one site in dth. On the other hand, among the 459 sites in TR patients, motor response leading to reduction of tremor drive was seen at 38 sites, of which 30 sites (79%) were noted in Vim nuclei, and five sites (13.2%) in vc nuclei; of the remaining sites, two were seen in Vop nuclei, one in dth, and no increasing tremor drive was observed in all area. In general, paresthesia was the most common response, which was found at 159 sites (45.8%) with DA and 216 sites (47.1%) with TR. Pain was only seen at one site in Wm of DA; warm/cold and vertigo could be seen in Vop, Vim, and vc nucleus respectively. No responses were shown at 156 sites (45%) in DA, and 201 sites (43.8%) in TR.

Isoptin SR was used in 65 essential hypertensive patients. 240mg Isoptin SR (German Knoll Pharmaceutical company) per day was used in group A (35 cases) for 6 weeks, and in group B (30 cases) for 24 weeks, BP in group A and B decreased obviously in the first and second week after treatment. Marked effective rate and total effective rate were 65.7% and 74.3% respectively in group A, and 70.0% and 83.3% in group B. There were no significant changes of HR in group A before and after treatment while there was a decrease of HR in group B (P<0.001). Left atrium (LA) decreased after 6 weeks in group A with an obvious increase of E/A ratio. There was significant decrease in LA, increase in E/A ratio, regression of IVS, LVPW and LVMI, but no changes in SV, CO, LVEF after 24 weeks of treatment of Isoptin SR in group B. E/A ratio was very sensitive and occurred earliest both in group A and group B. Side effects such as headache, dizziness, constipation, insomnia, peripheral oedema, sinus bradycardia occurred mainly in the first week of treatment. These symptoms disappeared gradually in the course of continued administration of Isoptin SR.

A successful method for constructing human chromosome 8q24.1 band specific probe pool by microdissection and microcloning is described in this paper. The probe pool was proved to be band-specific by fluorescence in situ hybridization. Through Southern blot analysis, 34 single copy DNA segments were obtained and four of them were sequenced. It is possible to provide useful landmarks for constructing human chromosome 8q24.1 physical map and STSs map.

This is China's pilot study in the assessment of the diagnostic value of serum soluble IL-2 receptor (sIL-2R) in gastric cancer. We measured its level by ELISA method in 45 patients with gastric cancer (without metastasis: 32; with metastasis: 5; recurrence: 8) 27 gastric ulcer, 27 superficial gastritis and 44 healthy controls. The mean-serum sIL-2R levels were significantly elevated in cancer patients, those with metastasis showed even higher levels than those without metastasis. These results suggested that sIL-2R can be used as a marker of host biological response in gastric cancer patients as well as a tumor marker for the diagnosis of the disease.

The isolation and purification of F A1 (MW 23-64 KD), F B1 (MW 24-54 KD), F A2 and F B2 (both MW 67 KD) of high molecular weight substances (HMS) from continuous ambulatory peritoneal dialysis (CAPD) dialysate of 2 end staged renal disease (ESRD) patients (A and B) were carried out by precipitation, desalting, gradient elution, chromatography and concentration. 0.1ml of tris-buffer, 0.2ml of uremic serum. 0.1ml of F A1, F B1, 0.2ml of F A2 were separately added to mouse bone marrow culture medium and lymphocyte culture medium, then colony-forming unit of erythroid (CFU-E), burst-forming unit of erythroid (BFU-E), colony-forming unit of granulocyte-macrophage (CFU-GM) and lymphocyte transformation (LT) were measured. We found that the uremic serum and F A1, F B1 could inhibit CFU-E, BFU-E very significantly (P<0.001) compared to the tris-buffer control, but could not inhibit CFU-GM. The uremic serum and F A1 could inhibit LT significantly (P<0.01) compared to the tris-buffer control, while F A2 could inhibit neither CFU-E nor BFU-E. If the dosage of erythropoietin (EPO) added to mouse bone marrow progenitor cell culture medium increased 3-6 times. F A1 could not express its inhibitory effect on CFU-E or BFU-E. Our data suggest that: (1) the F A1, MW 23-64 KD, F B1 MW 24-54 KD isolated from CAPD dialysate of 2 ESRD patients could inhibit erythropoiesis and suppress cellular immunity in vitro; (2) these HMS could be removed from uremic serum by CAPD, this may play a role in the improvement of uremic anemia and immunodeficiency; (3) increase of EPO dosage in mouse bone marrow progenitor cell medium could overcome the inhibitory effect of these HMS on CFU-E and BFU-E, this result could partly explain that high dosage of rHu-EPO can correct uremic anemia.

With overall analysis of symptoms and signs of myasthenia gravis (MG) basing on "Pi (Spleen) Deficiency" (脾虚) theory and with years of our clinical experience in treating MG, we performed a pharmacological study of Astragalus saponins and Buzhong Yiqi Compound (Tonic granulae invigorating vital energy) in 14 peripheral blood mononuclear cell (PBMNC) cultures from 10 MG patients. PBMNG from two groups of patients given dexamethasone (Dxm) and cobalt 60 (60Co) treatment were used as controls. The results showed that water soluble Astragalus saponins significantly reduced the titer of nicotinic acetylcholine receptor antibodies (nAchR-Ab) in the cell culture supernatants, from 418.8-2328 to nil in 6 cases, and from 1143-1235 to 43-157 fmol/ml in 2 cases, and that Buzhong Yiqi compound also had inhibitory immunoregulatory action.

In the evaluation of Chinese herbs (A), ear-acupuncture (B) and epidural morphine (C) to relieve postoperative pain and abdominal distension, sixteen male patients with primary liver cancer were observed. This study was conducted by means of orthogonal experiment and double blind, randomized design. The patients received various treatments according to the display of the orthogonal table L16(2)15 which corresponds to 2(3) factorial experiment design. C+ (morphine 2 mg) was given before the peritoneum was sutured. A+ (orally administered) and B+ were given 24 hours after operation. 50-100 mg of pethidine was given when the pain intensity VAS (0-100) exceeded 50-70. The observation parameters included plasma leucine enkephalin (LEK), postoperative total dosage of narcotics administered for 5 days, VAS for pain and pain reliever, abdominal distension, urinary retention, constipation, etc. The results were as follows: a. Patients who had received A (A+B+C+, A+B+C-, A+B-C-, A+B-C+); C (C+A+B+, C+A+B-, C+A-B+, C+A-B-), or B (B+A+C+, B+A+C-, B+A-C+, B+A-C-) produced better analgesic effects than those who had received placebo. The A, B, and C reduced narcotics 650, 450 and 550 mg respectively when compared with placebo. The effects of A and C were of statistical significance (P<0.05), while AB, BC, and AC interactions were not found; b. A and B minimized abdominal distension and urinary retention, while C prolonged them. As compared with the placebo, A and B accelerated restoration of bowel peristalsis (P<0.05, ANOVA). Both A and B decreased it for 165 hours, while epidural morphine prolonged it for 49 hours; and c.(ABSTRACT TRUNCATED AT 250 WORDS)