1979年 · 第92卷第03期

1,250 cases of pathologically documented chronic persistent viral hepatitis seen from January 1960 to June 1974 are analyzed. The presence of symptoms with normal liver function tests constitutes a clinical pattern of viral hepatitis which can be differentiated from post-hepatic syndrome by liver biopsy. Involving multisystems, the disease may present various clinical manifestations. Although the course may be long, the prognosis is good, rarely progressing into cirrhosis.

10 cases of vertebral fracture complicated by paraplegia were encountered in 1976 among Tangshan earthquake victims. There are 6 males and 4 females, 7 of whom were aged 20-40 years. All 10 cases had flexion compression fracture of the spine: T12 5 cases, L1 2 cases, L2 2 cases and L3 1 case, 5 had decompressive laminectomy performed after admission with satisfactory recovery of sensation, bowel movement and urination, but poor motor function. Motor function improved following anterolateral decompression. In this series, 2 cases were cured, 6 basically cured and 2 unchanged. Prior to anterolateral decompression, complete paraplegia was noted in 2 cases and partial paraplegia in 8. 3-4 months after operation, 3 cases were discharged without crutches, 4 with one or a stick, 1 with 2 crutches and 2 were unchanged.

A follow-up study was made of 140 cases of intrahepatic portal hypertension treated by splenorenal shunts during a 23-year period. The operative mortality was 4.3% and the 5-year, 10-year, 15-year and 20-year absolute survival rates were 67.8%, 52.0%, 50.0% and 30.0%. The assessment of hepatic reserve with a point score system is suggested, which seems to be more discriminating than Child's classification. Clinically, it is more helpful in the selection of patients for shunt operation as well as in the prediction of long-term survival rates. Prophylactically, splenorenal shunt achieves a satisfactory long-term survival rate, with a low incidence of post-shunt encephalopathy. But as elective or emergency surgery, it is likely to be followed by a high incidence of recurrent esophageal bleeding. For patients with acute hemorrhage or a previous history of esophageal bleeding, some other procedures such as portacaval shunt are preferable.

Brain metastasis is not uncommon in chorio-carcinoma, yet there have been very few reports about it in the literature. This paper is a clinical analysis and study of 98 cases with definite evidence of brain metastasis admitted to Capital Hospital from 1949 to 1975. The genesis and development of this disease and the methods of early diagnosis are discussed. A regimen of treatment with chemotherapy alone is proposed which has reduced the mortality rate of brain metastasis from 110%, before chemotherapy was used, to 46.2% from 1973 to 1975.

Harringtonine (HA) and homoharringtonine (HO), two new antileukemic agents, are submitted to experimental toxicity studies in mice, rabbits and dogs. The organs involved in rabbits and dogs after 5 or 7 days' treatment with either alkaloid are chiefly the gastrointestinal tract, heart and hematopoietic organs. Most deaths are attributable to cardiac dysfunction. In only some of the animals receiving lethal doses moderate hepatic and renal damage occur. When 3 courses of treatment are given no other significant sign of toxicity is observed. The cardiac and hematopoietic toxicities however appear to be moderately cumulative. All toxicities observed are dose-dependent, and completely reversible upon discontinuation of treatment. No significant delayed toxicity is observed during the observation period of 6 weeks or more. Neither inter- or intra-species difference nor sex-related difference in qualitative toxicity of HA or HO is observed. The established TDHS are 0.42 mg/kg of HA and 0.16 mg/kg/day×7 of HO for dogs. HO is much more potent than HA quantitatively but qualitatively they do not differ from each other.

Total reconstruction of the male genitalia has been performed for years by many authors, all the procedures carry the disadvantage of having many operative stages. 3 cases of total loss of penis were treated successfully with one-stage reconstruction. Each of them has a fairly good appearance and with a very adequate urethra with an external meatus opening at its distal ends.

Furbenicillin (BL-P 1597), a new semisynthetic broad spectrum penicillin, was evaluated in vitro in 2-fold tube dilution testing against 307 different clinical isolates in parallel with carbenicillin and ampicillin. Furbenicillin was shown to be more effective than carbenicillin aganist penicillin-sensitive gram-positive and gram-negative cocci as well as many gram-negative bacilli including Pseudomonas aeruginosa. About 82% of Ps. aeruginosa strains could be inhibited by furbenicillin at 12.5 μg/ml which is 16 times stronger than the antibacterial action of carbenicillin. The activity of furbenicillin against penicillin-sensitive organisms is similar to that of ampicillin. Furbenicillin demonstrated greater in vivo activity against species of experimental pathogenic bacterial infections than carbenicillin. The latter is 2-3 times less active than the former against mouse pseudomonas infection in tests.

Tetrandrine 汉防已甲素 is an alkaloid of the Chinese medicinal herb - Stephania tetrandra S. Moore 汉防已. It has been proved clinically to be an effective oral antihypertensive drug without serious side effects. This paper presents a clinical study of 3 groups of patients, 2 treated with tetrandrine and 1 with western medicine. 38 patients, of whom 37 had essential hypertension and 1 renal hypertension due to stenosis of the renal artery were treated with oral tetrandrine for 1 month with a total effective rate of 92.1%. 19 patients with essential hypertension were given intravenous tetrandrine for 2 weeks with a total effective rate of 78.9%. Administered orally, the drug is effective for all stages of hypertension. There is no significant relation between its therapeutic effect and the duration of illness. Oral tetrandrine can significantly lower the blood pressure of patients in the supine, standing or sitting positions without affecting the heart rate. No postural hypotension or other serious side effects were observed.

16 autopsied cases of cerebral embolism were analysed, including the source, duration, frequency, common position arid pathologic changes of the cerebral emboli as well as the lesions produced by them. Clinically such cases are apt to be misdiagnosed as cerebral thrombosis. Differentiations of cerebral embolism from cerebral thrombosis and of organized cerebral embolism from cerebral atherosclerosis are discussed.

Using a basic protein derived from glioma (GBP) as an antigen macrophage electrophoretic mobility (MEM) test was performed on 197 subjects. 98% of 55 normal persons showed negative results, 89.9% of 69 cases with brain tumor and 93% of 43 with other malignancies positive results, 15 cases with nontumor and non-neurologic disease negative results and 4 of 11 with neurologic disorders and 3 of 4 with fatigue and emaciation appeared positive. Our results support the hypothesis of a common antigen in human tumors as proposed by Field and Prichard et al. This test may be valuable in detecting brain tumors as well as other malignancies.