1985年 · 第98卷第10期

In 1981, we successfully treated a case of carbon monoxide poisoning associated with severe burn of the low back, the upper part of both things, lower abdomen and the perineum. A large sized filleted musculocutaneous flap, 83 cm in length; from the right lower extremity was used to repair the defect and reconstruct both buttocks.

A typical case of congenital nephrogenic diabetes insidipidus (a Chinese of pure Han nationality) followed up for 15 years is reported here. This proves that a new mutation may give rise to such a disorder. Early diagnosis and timely and correct management including therapy with chlorothiazide at the onset of disease were essential to alleviate or prevent the damage to his intelligence. This was done succesfully because the condition of hypertonic dehydration and high fever was not long enough to cause apparent mental retardation during infancy.

Prostaglandin E (PGE) including endogenous cytoprotection PGE induced by 20% ethanol can protect gastric mucosa, indicating that a way of preventing ulcer caused by drugs has been found. An increase of PGE has been observed in the gastric mucosa of patients with chronic atrophic gastritis and superficial gastritis. The PGE content of the in testinal mucosa in bowel inflammatory disease (BID) is significantly higher than that in colitis, irritable colon syndome and normal subjects, this finding may be of help in diagnosis and differential diagnosis of BID, especially Crohn's disease and may contribute co the understanding of the pathophysiology of the disease and the mechanism of sulphasalazine, prednisolone and Chinese medicinal herbs in inhibiting PGE biosynthesis.

15N-glycine was administered orally as a tracer to 3 patients with chronic renal failure (CRF) in the study of total body protein metabolism during the course of diet therapy. Five healthy subjects with matched age and sex served as controls. Patients on a diet providing 1.2 g protein/kg/day had significantly low total nitrogen flux (Q), rates of total body protein synthesis (S), catabolism (C) and S/Q, as compared with the controls. A reduction in daily protein intake to 0.6 g/kg/day resulted in marked increase in all these parameters, approaching those of the controls. In normal subjects, low protein intake did not affect the total body protein turnover signfiicantly. The results suggest that the adaptive response to restriction of protein intake is an efficient utilization of nitrogen entering the metabolic pool for anabolic purposes. This response becomes manifest and essential in patients with CRF and forms the basis for low protein diet therapy.

We studied the changes in concentratoin of five amino acids, which are neurotransmitters of their candidates, and CAMP in CSF from children with seizures, and from rabbits with seizures induced by intraventricular injection of FeCl3. We found more than one examined amino acids changed with the convulsion behavior and abnormal EEG. We proposed a unified index (ANT) to demonstrate their complex action: ANT=Glutamic acid content in CSF×Aspatic acid/Taurine×Glycine×GABA Our results also showed that the content of cAMP in CSP reflected the activity level of CNS to some extent.

This study reports the influence of acupuncture upon the peripheral blood lymphocytes (PBL) and E-rosettes as shown by alpha-naphthyl acetate esterase (ANAE) stain in 25 patients. The percentage of ANAE-focal patterns in PBL was increased markedly and ANAE activity was also correspondingly enhanced after acupuncture. Acupuncture effects not only increased E-rosette forming cells (E-RFC), but also influenced E-RFC ANAE patterns. In individual patients, the altered composition of the focal pattern tended to return to normal range 20 minutes and especially 24 hours after acupuncture.

A retrospective esophageal cancer (EC) survey was conducted in 1979 in Yangcheng County, the highest EC incidence area in Shanxi Province. The results revealed EC patients were concentrated in 8.19% of the 81,388 families in the county. Of the families with EC patients, 58% were single case families and 42% multiple case families. Of 11,446 deaths due to EC, 46%, were from the former and 54% from the latter. Of families with multiple cases, 65.18% had EC patients in 2 successive generations and 6.01% hand EC patients in 3 successive generations. In 63.78% of 475 parental couples who died of EC, EC patients could be found on both paternal and maternal sides or on either side. According to the data obtained in our survey, we are of the opinion that the proneness of the people to develop EC in this area lies in inherited susceptibility.

The effects of narcotics on the heart conduction system were studied in 51 rabbits. It was found that at equal efficacy dosages, the effects of high dose morphine, pethidine and fentanyl on the heart conduction system differ. Morphine 3 mg/kg injected iv did not influence the heart conduction system; fentanyl 30 μg/kg might improve both sinus node automaticity and sino-atrial conduction and pethidine 30 μg/kg might seriously harm the heart conduction system. So fentanyl may be an ideal narcotic in patients with sick sinus syndrome. But when the dosage of fentanyl was increased to 75 μg/kg, the sinus node was inhibited. The degree of pethidine effect upon the heart conduction system depends upon the dosage and rate of injection. The effects of controlled hypotensors on the heart conduction system were studied in 48 dogs. Trimethaphan (TMTP), sodium nitroprusside (SNP) nitro-glycerine (NG) and phentolamine (PA) were dripped iv respectively to lower the blood pressure by 30-40%. Five and 60 minutes after TMTP administration the atrio-ventricular junction was in inhibited and at 60 minutes the sino-atrial conduction was also inhibited. NG had no influence on the heart conduction system but SNP might inhibit the sinus node automaticity PA may also inhibit the sino-atrial conduction, so this agent contraindicated in patients with sick sinus syndrome or sino-atrial block.

The incidence of retinoblastoma among the group of 5-14 years of age was 14.2%. Retinoblastoma could not be precluded on the basis of a prolonged amaurotic cat's eye period and relatively quiescent appearance, neither could the extraocular growth of the malignant tumor be judged according to the length of cat's eye period or the level of intraocular tension, for a few normotensive cases were found with their optic nerves invaded by tumor cells. 11.7% were bilateral. So the contralateral examination should be made pre-operatively. Lymph node enlargement does not necessarily speak for metastasis; in fact, it was found in all stages of tumor development. Exceptional case has been found with enlarged optic foramen in whom the optic nerve was normal in appearance and pathologically. In 26.7% cases, when the optic nerves were found to be thickened in enucleation, no tumor cells were found pathologically. It was stressed that appropriate sectioning length of the optic nerve should be cut at first operation; burn by hot compress gauze during operation be avoided; the conjunctival incision be well-coadapted; and prosthetic eye should be fit on in time.