1994年 · 第107卷第12期

Four divers were compressed to 350 m to observe changes in hearing threshold, brainstem evoked response and acoustic impedance. The divers experienced no tinnitus, impairment of hearing, earache during compression. Examination showed that the threshold of lower frequency range of hearing was elevated because of the masking effect of the noise in the hyperbaric chamber. Changes in waveform and latency of brainstem evoked response were due to changes in sound wave transmission affected by the chamber pressure and a poor ratio of signal to noise in the hyperbaric environment with heliox. All these changes were transient. After leaving the chamber, the hearing threshold and brainstem evoked response returned to normal. Besides, there were no changes in tympanogram, acoustic compliance and stapedius reflex before and after diving. This indicated the designed speed of compression and decompression in the experiment caused no damage to the divers' acoustic system, and the functions of their Eustachain tubes, middle and inner ears were normal during the diving test.

To elucidate the effect of the internal fixation plates on the local bone blood supply, we used microangiography and scanning electron microscopy to observe the morphological changes of microcirculation in the cortical bones obtained from intact rabbit tibiae on which plates of two different stiffness had been fixed for comparison. The results indicated that both rigid stainless steel plate and less rigid methyl methacrylate plate could induce the bone microcirculation under the plate to undergo a process from early depression to late reactive recruitment. The features of the microcirculation recruitment such as vascular number, arrangement and dilatation varied with plates of different stiffness and were more obvious in the cortex fixed by rigid stainless steel plate.

The authors performed dynamic lumbar myelography with Omnipaque on 110 patients from 1990 to 1992, of them, 33 cases were diagnosed as non-bony lumbar spinal canal stenosis according to contrast medium defect seen on the lateral view of the myelogram. All such cases were operated on and their dynamic pathological findings during the operation were recorded to compare with the abnormal findings observed on the myelograms, there was a high coincidence rate of 88.7%. The authors believe that the fibrous degenerative changes make up the basis of dural sac compression and the dynamic compression in the spinal canal plays a very important role in causing the severity of the stenosis. As the dynamic pathological findings on the myelograms can not be well demonstrated on CT scanning and MR imaging, the dynamic lumbar myelography should be the method of choice for use in some cases.

Between December 1979 and December 1992, 15 patients with hypopharyngeal and cervical esophageal cancer were treated surgically. Total pharyngolaryngectomy and partial cervical esophagectomy were performed and the defects were reconstructed with cervical skin flaps in 2 cases. The free jejunal segments were used in 6 cases following total pharyngolaryngectomy and cervical esophagectomy, cervical esophagectomy (larynx preserved) was repaired with free jejunal graft in 1 case. The pharyngogastric anastomosis following total pharyngolaryngoesophagectomy were performed in 4 cases, one of them, used pectoralis major myocutaneous flap for resection of soft tissue and skin of the neck. The pectoralis major myocutaneous flap and forearm free flap in 1 case respectively were used to reconstruct the deficits of total laryngectomy and partial pharyngectomy, and partial pharyngolaryngectomy. In our series, 1, 3, 5 years survival rates were 73.3% (11/15), 50% (6/12) and 55.6% (5/9), respectively. The advantages and disadvantages of a variety of operative procedures and the cervical lymph nodes management will be discussed.

Recombinant DNA Yeast-Derived Hepatitis B Vaccine (RYHB vaccine) is comparable to and can replace Plasma-Derived Hepatitis B Vaccine (PHB vaccine) for the prevention of mother-infant transmission of hepatitis B virus (HBV), but the duration of immune efficacy of RYHB vaccine is not clear. This study indicates the long-term efficacy for the prevention of mother-infant transmission of HBV. One hundred and six neonates born to HBsAg-carrier mothers with HBeAg positive were randomly divided into two groups, one receiving 20 μg per dose of RYHB vaccine and the another receiving 20 μg per dose of PHB vaccine on the day of birth, at 1 month and at 6 months (three times). Physical examination and blood tests were performed for all infants at 6, 12, 24, 36, 48 and 60 months of age. The results showed that the protective efficacies at 6, 12, 24, 36, 48 and 60 months were 67%, 75%, 63%, 62%, 57% and 56%, respectively for the RYHB vaccine group and 58%, 76%, 51%, 41%, 24% and 18%, respectively for the PHB vaccine group. The protective efficacy was notably significant in the last two years. The study indicates that the duration of protective efficacy is over 5 years with RYHB vaccine, being longer than that of PHB vaccine. These recipients of RYHB vaccine showed no side effects, and the vaccine is regarded as safe and effective.

In this study, the serum levels of the pregnancy zone protein (PZP) were determined by PZP-single radial immunodiffusion in 708 cases of normal pregnancy, 207 with abnormal pregnancy and 188 with gynecological tumors. The results indicated that serum PZP levels in the normal pregnancy was detectable 5 weeks after gestation. It increased with the advance of gestational weeks, and reached a peak level in week 40. The serum PZP levels in 81.7% of patients with threatened abortion but not aborted were within the normal range, and also mostly in those with pregnancy-induced hypertension, intrauterine growth retardation (IUGR), anencephalus and ectopic pregnancy; the serum PZP levels in 51.6% of patients with invasive moles and 80.0% with choriocarcinoma, respectively, were lower than in normal controls. In gynaecological tumors, the serum PZP levels were significantly higher in patients with ovarian carcinomas than in those with other ovarian tumors (P<0.01), and in those with endometrial or cervical carcinoma than in those with uterine myomas (P<0.01). These results suggest that measuring the serum PZP levels may be used as an important reference index to observe threatened abortion and to identify trophoblastic diseases and gynecological tumors.

Microfiltration technique was used to measure white blood cell deformability (WCD) in one hundred and thirty patients with non-insulin-dependent diabetes mellitus (NIDDM or type II). It was found that WCD of the diabetics was significantly decreased compared with fifty controls (P<0.01) and further reduced with the rise of levels of plasma fibrinogen (Fg), plasma lipid, hemoglobin Alc (HbAlc) and fasting blood glucose (FBG), and also with the increase of age, the duration of diabetes, and the reduction of plasma magnesium concentration. It was shown that the decrease of WCD in diabetes mellitus was closely related to the degree of metabolic disturbance of the failure of diabetic control.

The cytotoxicity of malignant pleural effusion lymphocytes (MPEL) against autologous tumor cells (ATC) were compared with that of peripheral blood lymphocytes (PBL). It was demonstrated that the cytotoxicity of PBL was higher than that of MPEL (P<0.001), but the cytotoxicity and expansion of MPEL-activated by rIL-2 was much higher than that of PBL activated by rIL-2 (LAK cells) (P<0.001). This shows that local immune reaction of the pleural cavity of patients with malignant pleural effusion was in the state of suppression. MPEL activated are better effector cells than LAK cells in tumor adoptive immunotherapy.

Transesophageal echocardiogram (TEE) was performed in 33 consecutive patients with both rheumatic mitral stenosis and chronic atrial fibrillation to evaluate the usefulness of this technique for the detection of left atrial thrombi, mitral regurgitation before percutaneous balloon mitral valvuloplasty and iatrogenic atrial septal defect after the procedure. TEE correctly identified thrombi in 10 (30%) patients and significant mitral regurgitation in 5 patients who underwent surgical intervention. The remaining 18 patients underwent percutaneous balloon mitral valvuloplasty without evidence of systemic embolic event and obtained adequate outcome. Transesophageal color doppler echocardiography demonstrated left-to-right shunting flow through atrial septum in 5 of 7(71%) patients 3 days after the procedure and repeated TEE in 2 of these 5 patients showed no shunting after 6 months. In conclusion, TEE plays a definite role in the selection of patients for balloon mitral valvuloplasty and assessment of iatrogenic atrial septal defect.

Sixty-nine specimens from Tripterygium Wilfordii Hook.f. (TWH) users were investigated by electron microscopy. No macrophages were demonstrated in the 21 specimens collected prior to the administration of TWH. However, it was found in 23 out of the 48 semen specimens obtained following the TWH administration. The macrophages were functionally active as shown by the presence of a large number of cytoplasmic processes and pseudopodia on the surface, and primary and secondary lysosomes in the cytoplasm. The macrophages phagocytized sperm debris and degenerated or dead spermatids with formation of specific phagosomes. Around those macrophages, lymphocytes were commonly noted. The cytoplasmic processes of the two cell types could come into contact or even fuse with each other, leading to tight junction-like structure; in some of the contacts, the plasma membranes were found dissolved so as to form direct cytoplasmic linkage.