1995年 · 第108卷第08期

This study was designed to evaluate the efficacy of the newly developed Troponin T (TNT) enzyme immunoassay for predicting the prognosis of patients with angina pectoris. TNT, creatine kinase (CK) and MB isoenzyme of creatine kinase (CK-MB) were monitored in 134 patients with angina pectoris. There was no abnormality with any of these tests in 40 patients with stable angina pectoris and 30 patients with unstable angina pectoris of Class 1 and 2 according to Braunwald's criteria. None of them developed acute myocardial infarction or other cardiac events. Elevation of TNT concentration with normal level of CK and CK-MB was found in 34 of the 64 cases of unstable angina pectoris of Class 3. Among the 34 patients, 11 had acute myocardial infarction within 10 days during hospitalization. In contrast, only one of the patients with unstable angina pectoris of Class 3 with normal value of TNT developed acute myocardial infarction. As the incidence of angina pectoris is quite high clinically but only a small number of patients developed myocardial infarction, it is necessary to have a new assay of high sensitivity and high negative predictive value. TNT determination could meet these requirements as it had high sensitivity (92%) and high negative predictive value (98%) for the prognosis of unstable angina pectoris. If there is no rise of circulating TNT level, a favorable outcome can be expected with a high degree of probability. Determination of serum TNT level would be adopted as a routine procedure for evaluating the prognosis of angina pectoris and it is superior to other enzyme tests such as CK and CK-MB.

To study the electrophysiologic effects of endothelin-1 (ET-1), we used patch clamp and glass microelectrode techniques to investigate the effects of ET-1 on cardiac L-Ica, Ik and Ik2 in guinea pig ventricular myocytes. The prolongation of APD50 was induced and EADs was triggered by 50 nM ET-1 perfusion. L-Ica and Ik were enhanced by various ET-1 concentration from 1 to 50 nM with dose-dependence. Their steady-state activations of L-Ica and Ik shifted left with ET-1 concentration increments. ET-1 elicited a kind of GTP-dependent inward rectifier K+ current having a mean conductance of 82.36±1.27 pS. The open time and close time (both interburst intervals and burst durations) abbreviated with ET-1 concentration increase. The results suggested that EADs -ET evoked was ascribed to the prolongation on the plateau level, which resulted from L-Ica enhancement. The ET- evoked inward rectifier K+ current should be further studied.

In Zhang County of Gansu Province, 13 human cases of alveolar hydatid disease were reported up to 1990. However, the causative organism has not yet been described in animal hosts. In July 1990, postmortem examinations were made on 59 dogs (Canis familiaris) from the Caotan region of Zhang County. Of them, 6 were found to be infected with the adult worms of Echinococcus multilocularis. The morphological characteristics of the adult were compared in detail with those reported from different parts of China. Our adult specimens were closely resembling those of E. multilocularis reported from Ningxia. The role of domestic dogs in the epidemiology of alveolar echinococcosis in Zhang County was discussed.

In studying the relationship between human papillomavirus (HPV) and bronchogenic carcinoma, "high-risk" HPV 16, 18 DNA sequences were detected in samples from 50 lung cancer patients, 18 patients with benign pulmonary diseases and 4 fetal lung tissues by polymerase chain reaction (PCR) and dot-blot hybridization with biotin-labelled probes. The results showed that HPV 16, 18 DNA related sequences were found in 32% of lung cancer specimens, with 10 cases of HPV 16, 5 cases of HPV 18 and 1 case of both types. 48.15% (13/27) of squamous cell carcinomas were shown to be positive for HPV 16, 18 DNA. In addition, two adenocarcinomas and one small cell carcinoma were positive for HPV 16 DNA. No specimens from benign diseases tissues and fetal lung tissues showed positive results. These results suggest that primary bronchogenic carcinoma is related to HPV infection.

Mast cell-nerve relation is a new topic explored deeply in different organs, but little documentation could be found in the literature on the relation in human nasal mucosa. We carried out this study using immunocytochemistry and found that substance P (SP) terminals were present in human nasal mucosa from six cases of chronic rhinitis. SP terminals were often found to be adjacent to or have a direct contact with mast cells (MCs). Electron-microscopic studies revealed that MCs could contact nonmyelinated nerve terminals. These results have important implications in the understanding of the pathogenesis of neurogenic inflammation seen in nasal mucosa and will probably cast new insight into the future treatment of such disease.

A total of 750 six-month follow-up records of myopia treated with excimer laser photorefractive keratectomy (PRK) were analyzed. By 6 months, in group 1 (up to -6.00D, 587 eyes), uncorrected visual acuity was improved to 20/20 or better in 86.7% of treated eyes and 95.4% fell into the range of refraction of ±1.00D. In group 2 (-6.25D to -11.00D, 163 eyes), 74.5% of treated eyes had uncorrected visual acuity of 20/20 or better and 89.4% of the eyes were within±1.00D. The designed predictability of the two groups was the same (P>0.1). The refractive stability from 3 to 6 months between the two groups was not statistically different, and no severe complications were observed in these two groups. The excimer laser PRK for correcting myopia up to -11.00D appears to be effective, predictable, stable and safe in this study. The ideal outcome may result from the precise ablation quality of excimer laser, its computerized surgical manipulation and an appropriate postoperative management including detection of refractive indices by corneal topography and modulation by steroid.

To find the diagnostic methods for subclinical stage fat embolism syndrome (FES), we established an experimental animal model, using fat intravenous injection. The fat was obtained from the long bone marrow cavity of homologous dogs. Fourteen healthy mongrel dogs received 0.7 ml/kg fluid marrow fat injection and all of them developed FES within 48 hours. The blood samples collected from the pulmonary vessels by floating catheter and peripheral vein at different time intervals were subjected to blood gas analysis and were frozen sectioned rapidly. The sections were stained with oil red 'O'. Positive result was seen 2 hours after fat injection in both pulmonary and peripheral blood. Computer image analysis showed that the number and diameter of fat droplets in pulmonary vascular blood were obviously higher and larger than those in peripheral vein blood. These findings were correlated well with blood gas changes and clinical features. The demonstration of fat droplets from pulmonary or peripheral blood by oil red 'O' staining combined with blood gas changes (PaO2<7.99 kPa, P(A-a)O2>6.09 kPa) may be rapid and specific for early diagnosis of FES. In the treatment of FES, dexamethason can stabilize the cellular membranes and inhibit the neutrophil response to fatty acid and the release of phospholipase A2, arachidonic acid and platelet aggregation.

The long-term results of total meniscectomy in 60 patients were reviewed. The patients were followed up to 10 to 33 years. 58.3% of the patients had excellent or good results. Statistical analysis showed that the late results were related to the time of follow-up and not associated with the duration of disease before operation. Radiological degeneration of the knee was seen in 35 patients (87.5%), whereas no relationship of the degeneration to the clinical results was found. It is indicated that the menisci are so important in biomechanics that total meniscectomy should be avoided as far as possible.

Laser-Doppler flowmetry was employed in the observation of regional cortical blood flow (rCBF) after experimental subarachnoid hemorrhage (SAH) in anesthetized rats and the contents of endothelin (ET) in the cerebral-spinal fluid (CSF), plasma, hypothalamus, cerebral cortex, cerebellum and medulla were simultaneously measured. There was a biphasic change of rCBF after SAH. The contents of ET in CSF, plasma and hypothalamus rose prominently in the early stage after SAH, and the ET-increase in CSF and hypothalamus was earlier than that in plasma. The changes of ET contents in CSF correlated well with that in hypothalamus. Our results suggest that ET probably is an early important factor which induces cerebral vasospasm (CVS) after SAH. The increase of ET in CSF, which may originate from the hypothalamus, might play a more important role in the development of CVS after SAH than that in plasma.

The dorsal scapular nerve and long thoracic nerve of 10 cadavers (20 sides) and 36 patients with dorsal scapular nerve compression were studied anatomically. The origin of the dorsal scapular nerve of a section frequently shared a common trunk with the long thoracic nerve, and went through the scalenus medius anterointernally and posterolaterally with the presence of some tendinous tissues. Leaving the long thoracic nerve, it might give branches to the shoulder and the subaxillary region and finally have the branches join the long thoracic nerve again. The compression of the section near the origin caused discomfort and sourness of the neck, shoulder and back region. Clinically, the severance of the scalenus anterior and medius ameliorated or relieved the compression of the dorsal scapular nerve. Complete decompression required cutting of the scalenus medius and its tendinous tissue superficial to the dorsal scapular nerve. Among 24 sides of 22 patients undergoing surgery, the symptoms of 20 sides of 19 patients were completely or partially relieved.

Hepatocellular carcinoma (HCC), the second cancer killer in rural areas and the third cancer killer in cities, has resulted in 110000 annual deaths in China, which amounts to 40% of liver cancer deaths in the world.

Hunan Province is one of the high incidence areas of nasopharyngeal carcinoma (NPC) in China and ranks the fourth after Guangdong, Guangxi and Fujian. Consequently, the pathogenesis of NPC has been the focus of our study for many years.

Since the founding of new China, the status of tuberculosis (TB) has been greatly improved through effective control measures and application of research achievements. In the early 1950s, more than 90% of adults in Shanghai and Tianjin had been infected. Tuberculosis ranked the first among the leading causes of death in big cities and the mortality rate reached 169-259/100000 in Beijing, Shanghai, Tianjin, Guangzhou and Hangzhou. The estimated prevalence of tuberculosis in the urban area (3500/100000) was higher than that in the countryside (1500/100000).