1981年 · 第94卷第11期

The double antibody sandwich enzyme immunoassay (EIA) method with glass beads as solid phase is used to detect carcinoembryonic antigen (CEA) and α-fetoprotein (AFP) in sera of patients with bronchogenic carcinoma. The enzyme labelled antibodies are made from purified rabbit antibodies against human CEA and AFP linked with peroxidase using O-phenylene diamine as a substrate. The color reaction was examined for quantitative analysis by electro- photometer. Elevated serum CEA levels over 5 ng/ml were found in 2.9 of the 42 patient (69%) with lung cancer and 8 of 25 cases (32%) with benign lung diseases, but none of the latter had a level over 8 ng/ml. Only 3 of the 46 normal controls (6.5%) had positive CEA higher than 5 ng/ml. Serial observations of 23 cases of bronchogenic carcinoma treated with Polyporus Umbellatus 猪苓多糖 combined with Chemotherapeutic drugs were also examined. In 18 cases (78%), serum CEA concentration corresponds to the therapeutic effect after treatment, so it appears that the serum CEA level may be used for prognostic assessment. On the other hand only 2 of 30 cases with bronchogenic carcinoma showed positive serum AFP levels.

This paper reports 15 patients with alveolar echinococcosis of the liver in Gansu province and reviews 90 pathologically proven cases seen mostly in northwest China from 1960 t0 1980. The author uses surgery, mebendazole and traditional Chinese medicine. Geographical distribution, clinical data, pathologic characteristics, diagnosis and treatment are discussed.

The 12-14 year follow up of 5 eyes of 4 glaucoma patients who underwent subscleral sclerencleisis with excellent results shows that subscleral sclerencleisis is an operation of choice for organic angle-closure glaucoma with little inflammation and can be used in other types of glaucoma as well. Its tension-reducing effect may be due mainly to external drainage through anterior chamber and the episcleral tissue. Both the newly formed filtration track between the subscleral sclerencleisis and trabeculectomy are superior to and may be used as substitutes for the classic filtering procedures.

ECGs were taken with 30 precordial leads arranged in 5 rows and 6 columns in 100 healthy individuals and 120 patients. Tracings taken from the same subject and arranged in geographic order into an array gave a composite picture of precordial QRS mapping with distinct characteristics. For each component wave in the QRS complex, there was a definite center of peak activity spreading out in diminishing strength to its surrounding areas. From the pathologic findings in the precordial mappings of acute and chronic myocardial infarction patients, the authors tentatively put forward the following criteria for the diagnosis of myocardial infarction: presence of abnormal Q or q centers; widening of the "physiologic S area"; and presence of R sinks. For myocardiopathy, the criteria are: presence of Q center or abnormally deep, narrow and ectopic q center; deep S wave at S center or high R at R center; and presence of obvious R sinks. Besides, the authors have the impression that this composite picture by conventional ECG method was quite similar to the main pattern of synchronous isopotential surface mapping during ventricular depolarization and in our clinical practice proved to be simple and effective as, an adjuvant to the conventional ECG in diagnosis of many diseases.

153 cases of primary liver cancer (PLC) resected during 1958-1978 are reported. The resectability rate was 43.6% and operative mortality rate 12.4%. The 1-, 3-, 5- and 10-year survival rates were 56.3%, 31.5%, 23.6% and 21.0%. An analysis of factors influencing survival after resection demonstrates that patients with alpha-fetoprotein (AFP) normalized after resection, radical resection, tumor<5 cm, single nodule, subclinical stage, negative findings in nuclide imaging and mass survey patients have better prognosis. Of these factors postoperative AFP normalization and radical resection are of prime importance. It is concluded that early detection and early radical resection are essential to improving the prognosis.

156 patients with initial rheumatic fever (RF) attacks were followed up an average 10 years, it is found that the incidence of carditis in RF is not declining significantly in China. The severity of carditis clinical symptoms (as evidenced by cardiac failure and pericarditis) has decreased and the mortality has been greatly reduced. Recurrence rate and morbidity of residual theumatic valvular deformities are greatly diminished as well. The most important risk factor influencing the formation of chronic theumatic valvular disease (CRVD) is the severity of valvular lesions at the acute phase. Formation of mitral stenosis is more frequent in the female. Enlargement of cardiac silhouette, ECG abnormalities, joint lesions, cutaneous lesions, recurrence rate and use of steroid medication seem to be irrelevant to CRVD development. It seems that the severity of the RF clinical course and the results of long term follow up in this study lie between the 2 extremes of results in the West and other developing countries. In China the incidence of RF complicating cardiac lesion is not decreasing significantly, the percentage of complicating cardiac failure is similar to that of the West in the 1950s, but the lowered mortality, recurrence rate and CRVD incidence are approaching world levels.

Pulmonary valve echoes are valuable in assessing pulmonary arterial pressure and right ventricular hemodynamics. With the present technic some indices have been already obtained such as a wave amplitude and right ventricular systolic time intervals, which can be utilized to estimate pulmortary arterial pressure to recognize the presence of severe pulmonary hypertension. However, it is still a qualitative or semi-quantitative technic and this insufficiency needs further investigation to improve the accuracy of this noninvasive technic for estimating pulmonary arterial pressure.

The blood pressure lowering action of rhomotoxin (八厘麻毒素 ) was studied in 105 hypertension cases. The dose averaged l.0-3.0 mg and was given by intravenous drip within 0.5-2 hours. It was effective in 104 of the 105 cases. Average lowering of systolic pressure was 36.1% and of diastolic pressure was 30.1%. Action was very quick lasting l-4 hours. Rhomotoxin's blood pressure lowering action is not inferior to sodium nitroprusside.

Over a 20 year period, of l,079 esophageal cancer patients seen in 2 hospitals, 818 were given exploratory thoracotomies and 664 resected with only a 30% 5-year survival rate as the patients were already in comparatively advanced stages by the time they came for treatment. All tumors resected were squamous cell carcinoma. The risk of lymph node metastasis grows with depth of tumor penetration of the esophageal wall but is not related with tumor length. The authors suggest preoperative irradiation and resection despite lymph node metastasis and tumor penetration beyond the esophageal wall as there are some 5 survivals even with only palliative surgery in these cases. The higher the lesion is located in the esophagus, the worse the prognosis.