1994年 · 第107卷第11期

The fetal neocortical transplant (E15-17 days gestation) of Wistar rat was grafted to the corresponding neocortical region (frontal-parietal lobe) of the same strain in young rats (4-5 weeks old). On the 7th, 15th, 30th, 60th, 150th day after transplantation, the sections cut through the middle area of graft-host brain were examined by HE, Nissl, Glees stain, immunohistochemical technique for GFAP and NF, Nissl, Glees stain, immunohistochemical technique for GFAP and NF, acetylcholinesterase (AChE) histochemistry as well as horseradish peroxidase (HRP) retrograde tracing with light microscope. Some of the sections were also examined with TEM. The result showed that most immature neurons within the graft can survive, grow, differentiate and mature, and are similar to the structure of the neocortical neurons of host brain. This study also provides patterns of integration of the interface between graft-host brain varying with the proliferation of reactive astrocyte as well as graft-host reciprocal connection of fibers.

The atherosclerotic lesions from 4 major epicardial coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries) of 23 nonagenarians patients were compared with that from 23 patients aged 60-69. The arteries were cut into transversely 5 mm long segments and were examined by microscope. The inside circumferences of the lumen were measured by computerized morphometric analysis. The results showed that the numbers of atherosclerotic plaques, percentages of narrowing of the coronary arterial lumen and circumferences of the arterial lumen in both groups were similar. But there were much more fibrous and resting (silent) or regressive plaques in the group aged 90-99 years as well as less lipid and active or progressive plaques than those in the group of 60-69 years. The above morphological findings may be correlated with the fact that there was a similar incidence of coronary heart disease but a less risk of acute myocardial infarction in patients aged 90-99 years than those aged 60-69 years.

Limb-salvage surgery plays an important role in the treatment of osteosarcoma. Among 104 patients with osteosarcoma we managed from 1974 to 1993, 60 were treated with limb-salvage procedure. 44 patients with IIB tumor received adjuvant chemotherapy, and the five-year survival rate was 46.69%. The local recurrence rate of these 60 patients was 15%, the infection rate 11.7%, and the prosthetic mechanical complication was 13.3%. Our results suggest that limb-salvage procedures are not only possible but also can provide patients with better function.

To evaluate the effect of hepatic inflow occlusion on the liver remnant, three methods of inflow occlusion of the right outside lobe of liver, which was finally resected, were performed in 30 rabbits. The mortality rate of 12 animals (6 in Group I and 6 in Group II) undergone 30 minutes of portal triad clamping (PTC) and selective hepatic artery reserving (SHAR) was both 66.7%. No death occurred in Group III (PTC, n=6) and IV (SHAR, n=6) for 20 minutes of hepatic ischemia, but with an irreversible damage to the hepatocytes. The level of serum glutamic-pyruvic transaminase (GPT) in Groups III and IV animals rose to 282.17 U/L and 155.33 U/L on the first postoperative day and thereafter declining slowly to the preoperative level on the 5th and 3rd days, respectively. In Group V with selective hemihepatic vascular occlusion (SHHVO) serum GPT showed only temporary mild rise (112.83 U/L) on the first postoperative day and no hepatic pathologic change appeared. It is obvious that the function of the liver remnant can be best preserved during hepatic resection under SHHVO.

The macrophages mediated biodegradation of two biomaterials, collagen/hydroxylapatite (CHA) and beta-tricalcium phosphate ceramics (TCP), was studied in 24 male Kunming mice and 20 male C57BL/6 mice with histopathologic, histochemical and ultrastructural observation. It was demonstrated that macrophages infiltrated after CHA, TCP were implanted. The macrophages could be differentiated from fibroblasts and the other infiltrated cells for special cellular profile and strong acid phosphatase activity. Morphologically, monocyte-macrophages and infused multinuclear giant cell degraded CHA and TCP by phagocytosis and extracellular resorption. The carbonic anhydrase activity of macrophages was demonstrated by histochemical technique. It suggested that macrophages secreted H+ and accomplished the decalcification of calcium phosphate compound of CHA and TCP. We conclude that macrophages are the main mediating cells which degraded CHA and TCP intracellularly and extracellularly.

In order to diagnose accurately the type of acid-base disturbance (ABD) in patients with post-traumatic multiple organ failure (PMOF), arterial blood gases and electrolytes were determined 645 times on 112 patients with PMOF and the data were analyzed with the pre-estimated compensatory formula of ABD and the calculations of anion gap, potential bicarbonate, and blood chlorides. Simple ABD was found in 381 times of determinations and double ABD in 239 when only the formula was used in the analysis, while 264 times of simple ABD, 260 times of double ABD and 96 times of triple ABD were found when the formula was employed in combination with the calculations of anion gap, potential bicarbonate and blood chloride. The mixed types of ABD were increased by 49% (117 times) from 239 to 356 times and triple ABD was increased from 0 to 96 times. The findings indicate that the employment of the combined formula and the calculations of anion gap, potential bicarbonate and blood chloride is of great significance to assess ABD especially its mixed and complicate types in patients with PMOF. It is emphasized that along with the monitoring of blood gases, the determination of blood electrolytes and the calculation of anion gap and potential bicarbonate should be performed to determine the correct type of ABD.

By means of histological method and ultrasound cardiographic (UCG) examination, the left-right ratio of transectional area of muscle fiber of latissimus dorsi muscle (LDM) after non-dynamic cardiomyoplasty was 77.4±11.7% in Group I (3 weeks after operation), and 78.4±11.6% atrophy and hyperplasia of LDM, but the basical structure was retained. The ejection fraction (EF) decreased significantly after operation (P<0.05), but the difference between two groups was non- significant. Also, dynamic cardiomyoplasty was performed on a sheep. UCG showed the increased cardiac systolic function after operation. ATPase, succinodehydrogenase (SDH) and PAS examination implied the strengthening of fatigue-resistant ability in skeletal muscles after long-term electrical stimulation. So cardiomyoplasty is suggested to be a supplementary measure in treating end-stage heart failure.

Anastomotic false aneurysm (AFA) of the aorta is a potentially lethal complication after prosthetic grafting. Nineteen aneurysms were encountered in 18 patients within a 30-year period (1960-1991). There were 10 men and 8 women, aged 27-80 years (mean 58 years). In 14 patients, the prostheses were made of silk, in 2 were PTFE, and in 1 each Dacron or silk-Dacron cross-weaved. Patients with an intact AFA had a pulsatile abdominal mass, abdominal pain, an occluded graft and peripheral emboli. Five patients were asymptomatic. Clinical onset of AFA varied from 2 weeks to 12 years (mean 5 years). The accurate rate of diagnosis of single plane angiography was 75% (3 of 4), and computed tomography 100% (ten of ten). Ultrasound was used only once and suggested an AFA. Four AFAs were less than 5cm in diameter. Five patients refused operation and died in 2 years from rupture. Operative mortality was 11% (1 of 9). Treatment was resection of AFA and replacement with a new graft. Life-long follow-up is required for patients with an aortic aneurysm. All ratroperitoneal AFAs should be resected, since the outcome of rupture is poor.

Using enzymatic assay and radioimmunoassay, we studied the functional status of pancreatic islet in 50 patients with acute leukemia. Oral glucose tolerance test and insulin and C peptide release were made in 40 patients before and after treatment. 14 patients who revealed diabetic curve and delayed insulin and C peptide release before treatment showed normal values in 6 after therapy. Five patients with impaired glucose tolerance and decreased insulin and C peptide release before treatment showed normalization of these parameters following therapy. Five patients with normal pretreatment values disclosed abnormal post-treatment results. The remaining 16 patients displayed normal results both before and after therapy. Anti-insulin antibodies were negative, and glucagon level was normal in all the 50 patients. The red cell insulin receptor binding rate analysed in 47 patients was significantly higher than in controls (P<0.001). We considered that the disturbed glucose metabolism in acute leukemia was not uncommon mainly due to the dysfunction of pancreatic islet β cells as a result of islet damage by leukemic cells, the effect of corticosteroid and chemotherapy and the preexisting diabetes. Impaired glucose metabolism had no influence on therapeutic effect.

The aim of this study is to investigate the effects of nitric oxide, formed from L-arginine, on the production of endothelin-1 in vivo and in cultured endothelial cells. In mechanically ventilated anesthetized dogs (n=5), mean pulmonary arterial pressure (PAPm) and pulmonary vascular resistance (PVR) during hypoxic ventilation (FIO2=0.10) was 25±3.1 kPa and 68.7±10.2 kPa.s/L respectively. NG-nitro-L-arginine methylester (L-NAME), an inhibitor of nitric oxide synthase, increased the peak value of PAPm and PVR during hypoxic ventilation to 36.6±4.7 kPa and 158.4±25 kPa.s/L and its effect lasted for 2-3 hours. Meanwhile, plasma endothelin-1 level in the femoral artery increased by 20.9±7.1, 25.6±7.7, 28.6±7.9 pg/ml at the 60th, 120th, 180th minute after the injection of L-NAME respectively (P<0.05 vs hypoxic control before the injection). In cultured endothelial cells from umbilical veins, endothelin-1 level of culture medium in control group was 35.1±5.9 pg/105 cells/ml (n=9). L-NAME increased endothelin-1 level to 42.8±4.9pg/105 cells/ml (n=9, P<0.05) in case of 10-11 mol/L and to 43.0±4.7 pg/105 cells/ml in case of 10-7 mol/L (n=9, P<0.05). These findings indicate that endogenous nitric oxide is an inhibitory modulator of hypoxic pulmonary vasoconstriction and that nitric oxide inhibits the production of endothelin-1 in vivo and in cultured vascular endothelial cells.

The effect of selenium (Se) supplement on pregnancy was studied in 52 pregnant women with high risk factors of pregnancy induced hypertension (PIH). They were given natural Se dietetic liquid (100 micrograms/d) for 6-8 weeks during late pregnancy, and 48 controls were given placebo. They received similar routine prenatal care. The results revealed that Se supplement on the pregnant women prevented and decreased the incidence of PIH and gestational edema, and elevated the mother's blood Se level by 0.1008±0.091 ppm in the treated group while decreased by 0.0402±0.046 ppm in the control group (P<0.01). The umbilical blood Se level was 0.2756±0.100 ppm in the treated group and 0.1544±0.051 ppm in the control (P<0.01). The differences of the neonatal birth weight and the amount of postpartum hemorrhage between the two groups were not significant.