1997年 · 第110卷第04期

OBJECTIVE To evaluate the preliminary RESULTS of high myopia correction by microlamellar keratectomy (MLK). METHODS Seventy-three eyes of 43 patients with high myopia were treated by MLK. The preoperative refraction ranged from -7.00D to -32.00D (mean -18.45D±6.18D). All the operations were performed with the special apparatus for MLK. RESULTS At 6 months after surgery, in the 73 eyes except 2 with new other symptoms, all the uncorrected visual acuity and corrected visual acuity were better than or equal to their preoperative ones respectively. Uncorrected visual acuity was better than or equal to the preoperative corrected visual acuity in 51 eyes (71.83%). No severe complications occurred during and after operation. The postoperative refractive status was stable. CONCLUSIONS MLK is effective to reduce high myopia and has some special advantages as compared with radial keratotomy (RK), photorefractive keratectomy (PRK) and laser in-situ keratomileusis (LASIK). But influenced by several factors, the predictability of this procedure is merely fair. It is suggested that this kind of procedure must be done with excellent microsurgery equipments, microsurgical skills and much more clinical experience of managing corneal disorders.

OBJECTIVE To investigate the distribution of the tyrosine hydroxylase (TH) immunoreactivity in the cochleas of chinchilla and compare it with guinea pig. METHODS Ten healthy chinchillas and six healthy guinea pigs were used in this study. The surface preparation of cochleas were obtained by microdissection. The TH-like immunoreactivity on the surface preparation as examined by the avidin and biotinylated horseradish peroxidase macromolecular complex (ABC) technique and investigated with light microscopy. RESULTS TH-like immunoreactivity was seen in the region from modiolus to the habenula perforata. There are two different groups of fibers in this area, one is blood vessel dependent, the other is a blood vessel independent system. No TH-like immunoreactivity was present in the inner spiral bundle (ISB) and the tunnel spiral bundle (TSB) regions in chinchilla cochleas. TH-like immunoreactivity was found in the region from modiolus to the habenula perforata and the ISB and TSB regions in the organ of corti (OC) in guinea pig cochleas. CONCLUSIONS The presence of TH-immunoreactivity on the cochlea of chinchilla and guinea pig is different. TH-like immunoreactivity on chinchilla cochlea was involved only in the fibers corresponding to the sympathetic fibers on cochlea of guinea pig. No fibers corresponding to the dopaminergic olivocochlear lateral efferent system of guinea pig were found in ISB and TSB within the OC in chinchilla.

OBJECTIVE To investigate ultrastructurally the process of calcification and ossification in experimental fracture healing. METHODS A standardized fracture of the radius was made in rabbits. Undecalcified callus tissues from different fracture regions were subjected to ultrastructural observation under transmission electron microscope. RESULTS In the mitochondria and membrane-bound vesicles of the fibroblasts, osteoblasts and chondrocytes, high electron density calcium granules were seen. These granules provided raw materials for the deposition of calcium salt crystals. Around these cells, round, oval or irregularly shaped matrix vesicles could also be discerned, and they became calcified and formed flocculent calcospherules. Then in the Type I collagen fibrils around the fibroblasts and osteoblasts, and in the Type II collagen fibrils around the chondrocytes, calcium salt crystals also appeared. Innumerable flocculent calcospherules and calcified collagen fibrils coalesced together, expanded and finally turned into pieces of bone tissues. The fibroblasts also possessed the indispensable prerequisites for calcification and ossification in fracture healing. They either transformed into osteocytes or degenerated, perished and eventually were replaced by bone tissues. CONCLUSIONS Sequence of events taking place in calcification and ossification in experimental fracture healing was depicted. Calcification of matrix vesicles and collagen fibrils triggered these processes. Evidence of osteogenic role played by fibroblasts was provided.

OBJECTIVE To evaluate long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA) and the factors affecting its efficacy in Chinese patients. METHODS Two hundred and twenty-nine patients who underwent successful PTCA in this institution were followed-up by direct interview or letters. The rate of follow-up was 95%. The period of follow-up were 0.5-8.4 (with mean of 2.3±1.8 years). RESULTS Angina Pectoris recurred in 76 (33.2%) of the patients. Cox regression analysis revealed that the relative risk of recurrence of angina pectoris was increased among the patients with triple vessel disease and with history of hypertension. During the period of follow-up, 2 (0.9%) patients died, 6 (2.6%) had non-fatal acute myocardial infarction, 4 (1.7%) had coronary artery bypass graft surgery and 29 (12.7%) had repeat PTCA. The cardiac event-free survival rate calculated by Kaplan-Meier method was 84.8% at the first year and 70.5% at the eighth year. Cox regression analysis revealed that there were positive correlation between the relative risks of cardiac events and stenosis of lesions before PTCA and residual stenosis of LAD after PTCA. CONCLUSIONS The long-term efficacy of PTCA in Chinese patients was good. The RESULTS of this study suggest that to decrease the residual stenosis of LAD during procedures could probably decrease the relative risk of cardiac events during follow-up.

OBJECTIVE Apolipoprotein (apo) A-IV genetic polymorphism and its effect on serum lipids, apoA-I and apoA-IV were investigated in order to clarify the role of apoA-IV gene during the development of hyperlipidemia. METHODS Four polymorphic sites (codon 127, 167, 347 and 360) of apoA-IV gene (exon 3) were determined in two groups of inhabitants in Beijing (Group I: 145 healthy individuals; Group II: 41 cases of hyperlipidemic patients and controls) by PCR-RFLP technique. Serum concentrations of HDL-cholesterol (HDL-C), HDL3-C, HDL2-C, triglyceride (TG), total cholesterol (TC), apoA-I and apoA-IV were studied among the individuals with different genotypes of apoA-IV. RESULTS In Group I, frequencies of the alleles were 0.648 and 0.352 in codon 127; 0.972 and 0.028 in codon 167; 0.817 and 0.183 in codon 347. Two common alleles were 0.941 and 0.059 in codon 360. The results indicated that cases of codon 127 heterozygotes had a significantly higher serum TC level and cases of apoA-IV Ser127 homozygotes kept a markedly low TG level. Both homozygotes and heterozygotes which carried apoA-IV His 360 exhibited a significantly higher concentration of TC in comparing with that of apoA-IV Gln 360 homozygotes. The data from Group II showed that the allele frequency of His 360 had a significant difference between patients and controls. CONCLUSIONS Certain polymorphic sites of apoA-IV gene might influence the serum lipid levels in both healthy persons and hyperlipidemic patients. His 360 polymorphic position might have a relationship with the development of hyperlipidemia.

OBJECTIVE To observe the effects of anti-idiotypic monoclonal antibody 6B11 against ovarian carcinoma SKOV3 on immunocompetent mice BCF1 both in vivo and in vitro, so as to investigate the possibility of using it as a tumor vaccine. METHODS After immunization with 6B11 and normal mice (NM) IgG respectively on 2 groups of BCF1, blood, lymphocytes and tumor tissues were taken every other day. Ab3 was tested from blood samples. Subpopulations of lymphocytes were examined by FCM. The lymphocytes from immunized BCF1 were also cultured with SKOV3 to observe the chemotaxis and killing effects. Serial tissue sections were taken from BCF1 after immunization by SRCA implantation of SKOV3. TIL and visible cancer cells were examined carefully and compared with those in the controls. RESULTS Ab3 rose quickly after immunization with 6B11 but lowered down gradually till the 9th week. The CD4+/ CD8+ ratio of BCF1 changed markedly after immunization with 6B11. The immunized lymphocytes showed a beautiful chemotaxis with and killing effect on SKOV3. During in vivo examinations, TIL were found significantly earlier in the immunized BCF1 than in the controls and reached the peak earlier in the former (on the 6th day) than in the latter, while the viability of tumor cells was vice versa between the two groups. CONCLUSIONS 6B11 may be used as a vaccine for not only active immunization but also prevention of ovarian carcinoma.

OBJECTIVE To investigate some problems in relation to the prognosis of surgical treatment of cervical carcinoma through analysing the clinical data of 530 patients. METHODS Five hundred and thirty patients with stage I or II cervical carcinoma received surgical treatment between 1966 and 1988. There were 66, 288, 95 and 81 cases of stage IA, IB, IIA and IIB respectively. All patients underwent extensive abdominal hysterectomy and bilateral pelvic lymphadenectomy. The metastatic lesions of periaortic nodes in 18 cases were resected. Three methods of isolating ureter were used. The lymphangiography and dyeing of lymphaden was performed on 94 patients. RESULTS The five-year survival rate was shown to be correlated with the pathologic type, cytologic grade, clinical stage and nodal metastasis of cervical carcinoma. The five-year survivals in stage IA, IB, IIA and IIB were 95.5%, 93.4%, 90.5% and 77.8% respectively; in squamous carcinoma and adenocarcinoma, 91.5% and 78.1% respectively; in the group with nodal spreading and the group without nodal spreading, 70.2% and 94.6% respectively; in patients of stage IIB treated by the method of isolating ureter outside ureter, 83.1%; and in the group of lymphangiography and dyeing and the group not treated by lymphangiography and dyeing, 84.6% and 63.8% respectively. CONCLUSIONS The method of isolating ureter outside ureter has an applying value for stage IIB cervical carcinoma. Lymphangiography and dyeing of lymphaden plays a role in raising the rate of nodal dissection.

OBJECTIVE To evaluate the relationship of p53 alteration and myc family gene overexpression with the clinical characteristics of lung cancer. METHODS A series of 59 resected primary lung cancer specimens was analyzed for p53 gene by DNA/PCR sequencing and immunohistochemistry technique, and for myc family genes by RT-PCR methods. RESULTS Thirty-seven of 57 tumors were found to have p53 mutations or/and p53 protein accumulation. The presence of p53 alteration was not related to tumor size, lymph node metastasis, stage and relapse. Forty-seven cases were analyzed for myc family genes. The results showed that there was a positive correlation between unregulative expression of myc genes and the above mentioned clinical parameters. Our finding also showed that 19 of 30 cases (63%) with p53 alteration had myc gene overexpression which occurred in 63% and 76% cases with stage III and relapse, respectively, which was higher than 27% and 22% with p53 alteration but no myc gene overexpression and 50% and 71% with p53 negative but myc gene overexpression. CONCLUSIONS p53 alteration is a vital genetic event in the earlier stage of lung carcinogenesis, but not a prognostic marker. Myc family genes overexpression may be regarded as one of the independent prognostic determinants in lung cancer. The cooperation between p53 alteration and myc gene overexpression may occur during progression of lung cancer, but prognostic determinant is myc gene overexpression.

Hepatocellular carcinoma (HCC), a fatal malignancy in the past decades, has surpassed gastric cancer to be the leading cancer killer in the rural areas of China, and ranked second in the cities. However, gradual improvement of the overall prognosis in patients with HCC has been observed in recent years.

Oncology is rapidly gaining acceptance as a medical discipline through Asia. However, there is a need to increase awareness that the epidemiology, clinical spectrum and necessity, and management strategies for cancer in our regions are different from those in Western countries.

OBJECTIVE To compare the efficacy of transcranial Doppler ultrasound (TCD) and digital subtraction angiography (DSA) in identifying the clinical and hemodynamic relationship between intra- and extra-cranial circulation and subclavian steal syndrome. METHODS Sixteen patients were collected. The intra- and extra-cranial arteries were insonated with Doppler ultrasound. DSA and brain CT were performed in all patients. The relationship between the grade of arterial stenosis showing in DSA and the flow direction showing in TCD was studied. RESULTS TCD showed reversal flow of the vertebrobasilar artery in 13 patients, normal flow in 3, which was influenced obviously by fist-clenching. In the hyperemia test, the flow velocity and the direction changed significantly in all patients. The steal phenomenon of the middle cerebral artery (MCA) was coincident with that of the arterial cerebral artery (ACA) in 2 cases. Stenosis of MCA or ACA was found in 5 cases (31%). Nine patients were treated with arterial bypass or angioplasty. TCD was performed during the follow-up. CONCLUSIONS Reversal flow of the vertebral artery may occur in rest or only in exercise, depending on the grade of subclavian arterial stenosis. Hyperemia test is the most sensitive index. It is necessary to monitor blood flow in the MCA and basilar artery in hyperemia test. The coexistence of intra- and extra-cranial arterial stenosis is common.