1996年 · 第109卷第10期

OBJECTIVE To explore the pathogenesis of glucose metabolic disorder and insulin resistance in critically ill children under severe stress. METHODS To test glucose, lactate, glucagon, insulin, c-peptide, cortisol levels in 50 critically ill children. While we measured 125I-insulin binding to erythrocytes of 13 critically ill children who had hyperglycemia and hyperinsulinemia. Glucose and lactate were measured biochemically. Insulin, c-peptide, cortisol and glucagon were determined by RIA. Erythrocytes insulin receptor was detected by insulin radioreceptor assay. RESULTS Glucose, lactate, insulin, c-peptide, glucagon, cortisol, insulin/glucose, insulin/glucagon ratio in patients were higher than those in normal controls (P<0.05). As compared with normal controls, the maximum 125I-insulin bound and insulin receptor number per cell were significantly lower (P<0.01). But there was no difference of mean value in receptor affinity (P>0.05). CONCLUSIONS Hyperglycemia is common in critically ill children during stress, which may be attributed to hormones disturbance and tissure insulin resistance. Insulin receptor defect due to comprehensive factors was one of the important causes for insulin resistance. The blood glucose level can be used as an predicting index in ICU.

OBJECTIVE To investigate the current trend of use and abuse of antianxiety drugs in Beijing residents in 4 urban and 2 rural areas. METHODS A cluster sampling household survey of 6567 subjects out of 3000 families was made by 6 local grass roots mental health centers collaboratively. Screened with designed questionnaire, the positive addicted subjects were examined with present state examination (PSE), eysenck personality questionnaire (EPQ) and social disability screening schedule (SDSS) to detect their psychosocial status. RESULTS Benzodiazepine (BZD) has been widely prescribed and the rate of usage for 1 year is 61.82‰, whereas the rate of dependence is 16.29‰, constituting 1/4 of long-term users. This study also indicates that Valium is a most preferred drug among all available BZD used by the majority of addicted subjects. CONCLUSIONS It is concluded that the reported dependence is not epidemic but iatrogenic in nature attributable to persistent misuse of BZD. It is stressed that guideline of rational clinical application of BZD should be laid down so as to markedly reduce further possible misuse and abuse of the drugs of this kind.

OBJECTIVE Colchicine has been used clinically to treat hepatic cirrhosis caused by multiple etiologies. MATERIALS AND METHODS The effect of colchicine on the liver fibrosis of mice infected with Schistosoma japonicum were studied. The morphological observation and morphometric analysis of the infected and untreated, and infected and treated groups were proceeded under the light microscopy, and morphological observation was made under electron microscopy. RESULTS The results of morphometriic analysis in histological sections showed that the collagen fibers area per schistosome's egg was decreased in the infected and treated groups 10 to 13 weeks after infection. The decrease in the group of 13 weeks was significant statistically. The egg numerical density on area increased continuously from 10 to 13 weeks in both untreated and treated groups in similar degree. The ultrastructural study showed the accumulation of collagen fibrils around the hepatocytes and in the space of Disse decrease and ultrastructural lesion of hepatocytes get recovery in the treated group. CONCLUSIONS These findings suggest that colchicine has therapeutic effect on schistosomal liver fibrosis, through not only killing off the schistosome but interfering the metabolism of collagen.

OBJECTIVE To investigate the Entamoeba histolytica living in the low oxygen concentration colon of the host and how does it survive in the circumstance after invading the tissues with high oxygen concentration while obtaining oxygen without being damaged by the toxins. MATERIAL AND METHODS E. histolytica cultured for 48 hours was collected, centrifuged, rinsed, ultrasonically shattered and again centrifuged, and the activities of superoxide dismutase and the catalase in the supernatant were determined. The catalase and peroxidase were identified by the electron microscopic enzyme cytochemical reaction technique. RESULTS E. histolytica contained 122.42±15.47 U/mgpr of superoxide dismutase, 126.05±17.04 K/mgpr of catalase and peroxidase, and all of them are detoxifying enzymes. Catalase and peroxidase were located within microsomes and lysosome-like organelles respectively. CONCLUSIONS E. histolytica contains the detoxifying enzymes as superoxide dismutase, catalase and peroxidase, that may prevent the aerobic metabolism from being poisoned by the activated oxygen free radical (superoxide anion radical and hydrogen peroxide) produced in this process, suggesting that the detoxifying function of these enzymes play an important defensive role in the survival of E. histolytica.

OBJECTIVE To investigate the status of DNA methylation in gastric carcinogenesis. METHODS We analysed methylation pattern of c-myc, c-Ha-ras oncogenes by southern blot hybridization. DNA from cancerous, paracancerous and non-cancerous area of surgically resected samples in 21 cases of advanced gastric cancer were digested with MspI/HpaII and hybridized with the two genomic 32P labelled probes. In addition, the level of total genomic DNA methylation was measured by incubating DNA with 3H-S-Adenosylmethionine (3H-SAM) in the presence of a methylase which methylates all the cytosine residues that are in the double CpG (cytosine-guanine). RESULTS The results indicated that both c-myc and c-Ha-ras oncogene fragments containing CCGG sequence were hypomethylated in DNA samples from cancerous (10/21 and 5/10) and paracancerous (13/21 and 4/10) areas. Moreover, the level of total genomic DNA methylation in cancerous tissue was significantly lower than that in non-cancerous and paracancerous mucosa tissues (P<0.05). The results from two methods are incompletely alike. CONCLUSIONS These results supported a strong correlation between DNA hypomethylation and gastric carcinogenesis, particularly methylated pattern of c-myc and c-Ha-ras oncogenes fragments containing CCGG sequence was abnormal in gastric mucosa tissue from gastric cancerous and paracancerous areas.

OBJECTIVE To investigate 1) the glomerular mRNA expression and protein activity of antioxidant enzymes (AOEs) including superoxide dismutase (SOD) and glutathine peroxidase (GSH-Px) and the glomerular content of lipid peroxide-malondiadehyde (MDA), 2) the effects of probucol (P), a potent antioxidant agent on these AOEs and MDA levels, in the chronic phase of subtotal nephrectomized rats. METHODS The adult male Spregue-Dawley rats were randomly divided into three groups at the first week after subtotal renal ablation. Group 1 was sham rats (sham n=8), group 2 underwent 5/6 nephrectomy without special therapy (5/6 Nx n=8), and group 3 with 5/6 nephrectomy received probucol (5/6 Nxs+P n=8) at a dose of 1% in the rat chow. At the 12th week after P was administrated, all of the rats were sacrificed to remove left kidney for the determination of glomerular level of MDA, activity of SOD, and GSH-Px, glomerular mRNA expression of AOEs by Northern blot analysis as well as a histological examination. RESULTS In 5/6 Nx, serum cholesterol, proteinuria increased and creatinine clearance decreased progressively with age as compared with that in sham. Those abnormalities as well as glomerulosclerosis index (GI) ameliorated with the administration of probucol at the 12th week after subtotal nephrectomy [GI: sham 3.12±1.20, P<0.01 vs 5/6 Nx 5/6 Nx 188.6±25.1; 5/6 Nx±P, 106.9±17.6, P<0.05 vs 5/6 Nx]. The probucol therapy also significantly improved the decrease of glomerular Mn-SOD and GSH-Px both at mRNA level and protein activity and the increase of glomerular MDA content. CONCLUSIONS We demonstrated a deficiency of glomerular AOEs in the chronic phase of remnant kidney, which may contribute to the progression of renal injury. The protective effects of probucol on both renal functional impairment and the development of glomerulosclerosis may be partially associated with improving surviving glomerular AOEs.

OBJECTIVE To investigate the role of platelet activating factor (PAF) in the hypoxic pulmonary hypertension. MATERIAL AND METHODS Fifteen of 30 male Wistar rats were exposed to hypoxia for 3 weeks, and another 15 rats served as controls. The pulmonary arterial pressure was examined by catheterization. The sections of rat lung were treated by the avidin-biotin-peroxidase complex method to expose the location of PAF. RESULTS The rats developed pulmonary hypertension and right ventricular hypertrophy after hypoxic exposure. Under the light microscope, PAF is distributed on the vascular and alveolar walls of normal lung, and the content of PAF in the lung of rats with hypoxic pulmonary hypertension are remarkably higher than those of normoxic controls. CONCLUSIONS PAF plays not only a physiological role in the rat lung, but also a pathophysiologic role in hypoxic pulmonary hypertension.

OBJECTIVE To investigate the effects of breathing exercise on chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS 324 patients stable COPD were randomly assigned to either the breathing exercise group (Group I) or control group consisting of placebo (Group II). The maximum respiratory pressure (320 cases) and transdiaphragmatic pressure (129 cases) were monitored via RMS-I and Type-2 pressure measurements. The breathing exercises were taught and checked by experienced specialists periodically. Comparison was made between Group I and Group II using maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), diaphragmatic pressure (Pdi) and maximum transdiaphragmatic pressure (Pdimax) after 1 to 20 months. RESULTS In Group I MIP increased by 30.42%, MEP 32.10%, Pdi 30.94% and Pdimax 65.59% (P<0.001). No significant changes were observed in Group II given the placebo. The MIP, MEP, Pdi and Pdimax were 6.95%, 2.92%, 14.63 and 9.05% respectively (P>0.05). CONCLUSIONS Breathing exercise has a potent and long lasting effect on respiratory muscle contraction. The methods mentioned above can be used as standard quantitative index for contractile properties of respiratory muscle.

OBJECTIVE To further study the contribution of dopamine system to the local growth controlling mechanisms, a dose related response of 6-hydroxydopamine (6-OHDA) was studied by recording electroretinograms (ERGs). METHODS The spectral sensitivity of the b-waves and spectral efficiency function of oscillatory potentials (OPs) including OP1, OP2 and OP3 in 4 different doses group were measured. The effect of ascorbate that must be contained in solution of 6-OHDA was first tested with the spectral sensitivity of the b-waves and a correlation between response of the OPs and age, as well as a difference in both own eyes was analyzed for determining an intra-subject and inter-subject variance. RESULTS An enhanced response was found in OP1, OP2 with doses of 175 μg and OP3 with dose of 150 μg, and the effect of OPs was mainly in wavelength from 620 nm to 480 nm. No significant increase was found in the spectral sensitivity of the b-waves. The dose 200 μg seemed to be toxic to the retina estimated by both spectral sensitivity of the b-waves and spectral efficiency function of the OPs. CONCLUSIONS The dose 175 μg and 150 μg of 6-OHDA yielded an effect on the chicken retina.

OBJECTIVE To evaluate whether intramedullary tumor of the cervical spinal cord is amenable to aggressive surgery and to clarify surgical timing and important points for tumor removal. PATIENTS AND METHODS Fifty-eight patients with intramedullary tumor of the cervical spinal cord were examined by magnetic resonance imaging and treated by microsurgery in Huashan Hospital between May 1988 and December 1994. The results were analysed by F or Chi square tests. RESULTS Tumors were totally resected in 50 cases (86.2%), subtotally resected in 7 and partially resected in 1. Forty-five (77.6%) patients had their neurological status improved postoperatively. Most patients with moderate neurological deficit can recover remarkably after total tumor removal. Laser surgery is especially helpful for treating lipoma. CONCLUSIONS Intramedullary tumor of the cervical spinal cord is amenable to total tumor removal. Operation is suitable when a patient presents moderate neurological deficit. Proficient surgical technique and standards for total tumor resection are essential for good RESULTS . Preoperative radiotherapy contributes to difficult surgery and poor prognosis, and is not recommended.

In recent years, remarkable advances have been made in otology. The basic research of otology appeared to be a leading role in otolaryngology-head and neck surgery. Otologic neurosurgery became the common procedure at a level of prefectural hospitals, and patients with hearing disorders and vertigo were benefited greatly from the new and improved diagnostic techniques. The progress in this fild is reviewed as follows.