Showing papers in "Chinese Medical Journal in 1991"

Bacterial translocation and multiple system organ failure in bowel ischemia and reperfusion.

Abstract: Portal circulation was reduced to 50-60% for one hour by partial occlusion of the superior mesenteric artery for the purpose of studying the relationship between reperfusion injury, bacterial translocation and multiple system organ failure. Forty dogs were divided randomly into four groups, and 1 x 10(10)/kg E. coli O111B4 were fed to each animal 12 hours before operation. Group I constituted the controls, in which sham operations were performed. The experimental procedure was completed in all the animals of the other three groups. Rubia yunnanensis, an anti-oxidant, was given to group III. Amikacin was given to group IV. The results showed that group II was characterized by bacteremia, hypoxemia, and hypotension as compared with group I. The levels of superoxide dismutase (SOD) in the whole blood were markedly lowered and malondialdehyde (MDA) values significantly elevated in group II after reperfusion compared with group I. Plasma levels of anaphylatoxin C5a and B2 (TXB2) were significantly raised in group II beginning with the reperfusion when compared with groups I, III and IV. Pathological changes in the intestine, liver and lung were remarkable only in group II, including acute necrosis of the intestinal mucosa, granulocyte infiltration, hemorrhage and edema of the lung, degenerative changes of myocardial and hepatic cells, and bacterial invasion of the blood, liver and lung. These results suggested that bowel ischemia and reperfusion may promote gut barrier failure and bacterial translocation, then contribute to the development to multiple system organ failure (MSOF) by allowing bacteria or endotoxin normally contained within the gut to reach the portal and systemic circulations where it fuels the septic process. Oxygen free radicals, anaphylatoxin and thromboxane may be potential factors in the development of gut barrier failure and MSOF.

Anti-lipid peroxilative effect of ginsenoside Rb1 and Rg1.

Abstract: It has been reported that Ginsenoside can increase body resistance to many harmful factors and protect tissues from damage when an organism is in stress. To understand the mechanism of this action, a study on the antioxidative effect of Ginsenoside Rb1 and Rg1 was carried out. Results showed that Ginsenoside Rb1 and Rg1 could inhibit lipid peroxidation of rat liver and brain microsomes and that Rb1, at the final concentration of 10(-4)-10(-3) mol/L, could scavenge O2-. induced by liver microsome-NADPH-gossypol system. In in vivo experiment, Rb1, at a dose of 50 and 25 mg/kg/day x 3 ip, inhibited MDA formation in liver homogenate of rats by 26.8% (P less than 0.05) and increased the activities of catalase and GSH peroxidase by 47.2% (P less than 0.001) and 96.4% (P less than 0.001), respectively. However, no change in the activity of superoxide dismutase was found in liver cytosol of rats treated with Rb1.

Antithrombotic effects of Andrographis paniculata nees in preventing myocardial infarction.

Abstract: In 16 dogs the endothelium of the left anterior descending coronary artery was injured mechanically. Then a copper wire was inserted into the lumen as a choke of flow and the vessel was slightly compressed from outside by a constrictor. Eight dogs had been treated beforehand with a preparation of flavone extracted from the root of the Chinese medicinal herb Andrographis paniculata (TFAP). In the control group, saline solution was given, the epicardially recorded ST segment started to elevate within 15 minutes, the platelet aggregation rate and the plasma levels of TXB2 increased rapidly, whereas the level of 6-k-PGF1 alpha remained stable. Platelet cGMP rose continuously; however, platelet cAMP rose only at 60 minutes. Histological findings confirmed the occurrence of arterial thrombus and myocardial necrosis. Contrariwise, in the pretreated group there was no elevation of the ST segment, plasma 6-k-PGF1 alpha and platelet cAMP were increased, the production of TXB2 and aggregation of platelets were inhibited, and no thrombus or myocardial infarction was induced. All data suggest that TFAP might promote the synthesis of PGI2, inhibit the production of TXA2, stimulate the synthesis of cAMP in platelets, impede aggregation of platelets, and thereby prevent the formation of thrombi as well as the development of myocardial infarction.

Cervical nerve root transfer from contralateral normal side for treatment of brachial plexus root avulsions.

Abstract: The authors had designed cervical root nerve transfer from the contralateral normal side for the treatment of brachial plexus root avulsions in August 1986. Since then, the operation was performed in 50 cases. Follow-up studies showed that resection of C-7 root from the healthy side produced no long-term ill effect except numbness and pain of the fingers and weakness of gripping strength shortly after the procedure. In 10 recipient nerves of 9 cases with follow-ups of more than 2 years, satisfactory results were seen in 7. This is a new approach for the treatment of persistent cases of brachial plexus avulsion.

Parkinson's disease in China. Coordinational Group of Neuroepidemiology, PLA.

Abstract: An epidemiological study on the incidence and prevalence of Parkinson's disease (PD) was carried out in 29 provinces, cities and autonomous regions in this country in 1986. The survey was conducted in 117 areas, and 566 patients with PD were found among 3,869,162 persons examined, giving a point prevalence for men and women of 16.9/10(5) and 12.4/10(5), with the highest prevalence after the fifth decade of age. The disease was most prevalent in the southern part of China, especially in Hunan and Guangxi provinces. The incidence was 1.5/10(5)/yr in 1986. Both the prevalence and incidence of PD in China are lower than those in the white race and Japanese.

Stroke in urban and rural areas of China.

Abstract: A large-scale population survey was conducted to clarify the degree of harm and feature of distribution of stroke in China. 5 800,000 of a billion people were investigated in 29 provinces and cities excluding Taiwan province. The incidence, prevalence and mortality were standardized by direct method using the world standard population. The incidence of stroke was 109.95 per 100,000 people in 1986 and its 95% CI (confidence interval) 107.25-112.65 per 100,000. The age-standardized incidence was 115.87/100,000. The point prevalence of stroke was 245.49 per 100,000 people on December 31, 1986 and its 95% CI 241.57-249.61 per 100,000, with an age-standardized prevalence of 259.86 per 100,000. The mortality of stroke was 76.78 per 100,000 in 1986 and its 95% CI 74.52-79.04 per 100,000, with an age-standardized mortality of 80.94 per 100,000. There was a tendency for the rates to increase gradually from south to north and to decrease progressively from east to west. The models of linear regression were established between latitude and rates as well as between longitude and rates. The incidence, prevalence and mortality of stroke differed significantly in various topographic areas. They were much higher in cities than in rural areas, and much higher in men than in women. The incidence, prevalence and mortality increased with age, and their relationships fitted in Logistic curve well.

Twenty-item behavioral neurological assessment for normal newborns in 12 cities of China.

Abstract: Based on the method of Brazelton and Amiel-Tison for behavioral neurological measurement in the newborn and our own experience, we formulated a 20-item neonatal behavioral neurological assessment (NBNA) For setting up a practical method and a normal range of its scores in China, we examined 714 normal newborns (male 369, female 345), with NBNA at the age of 2-3, 12-14, 26-28 days for a total of 2,142 times, in 12 provinces of China from May to October 1988 NBNA contains 5 clusters: behavior (6 items); passive tone (4 items); active tone (4 items); primary reflexes (3 items); and general assessment (3 items) Each item has 3 scales (0,1,2) Twenty items have a maximum of 40 scores Among the 2,142 times examined, 904% of the 714 newborns had 39-40 scores, 97% greater than 37 and none below 35 Measurements of the first, second and third time revealed that the total scores increased with age The difference was statistically significant The abilities of auditory and visual orientations and active neck tone improved obviously with age NBNA shows distinct stability and reliability The score is not influenced by geographic location; the scoring system is simple and the manipulation takes only ten minutes

Recent studies on antimalarial efficacy of piperaquine and hydroxypiperaquine.

Abstract: Piperaquine and hydroxypiperaquine seem to be successful candidates of antimalarial drugs in China. Their antimalarial efficacy, experimental resistance, combination, mode of antimalarial action and clinical trials are described briefly.

Lumbar intervertebral disc prosthesis. An experimental study.

Abstract: To provide a more effective treatment and improve the outcome of surgical treatment of lumbar intervertebral disc protrusion, the values of lumbar intervertebral disc prosthesis (LIDP) were investigated. LIDP was specially designed and made of silicone rubber. The properties of material mechanics were investigated by compressive test and damage test of LIDP specimens. The biocompatibilities of LIDP were observed experimentally in monkeys. The surgical applicabilities were studied by in vitro experiments of fresh human lumbar spine. The results showed that LIDP has the advantages of good biomechanical applicability, biocompatibility and surgical applicability. LIDP is able to maintain the intervertebral space, stress balance and stability of the lumbar spine. after lumbar intervertebral disc excision, the replacement of LIDP could restore the functions of the lumbar spine and improve the curative results of disc excision.

Transfer of upper pectoralis major flap for functional reconstruction of deltoid muscle.

Abstract: Since January 1984, functional reconstruction of the deltoid muscle using transfer of the upper part of the pectoralis major muscle has been performed in 7 patients with deltoid dysfunction. 5-20 months follow-up (average 11) revealed marked improvement in 6 patients. During the operation, the superior and inferior parts of the pectoralis major muscle were bluntly dissected and sectioned. The upper part of this muscle was turned over and transferred to the site normally occupied by the deltoid muscle. The transposed muscle contributed to both abduction and flexion of the shoulder. The efficacy of abduction was reinforced by the increased arm of action.

Effects of Cordyceps sinensis on murine T lymphocyte subsets.

Abstract: It was shown by flow cytometry analysis that crystalized preparation of Cordyceps sinensis (Cs-Cr) caused significant elevation of the number of T helper cells and Lyt-1/Lyt-2 (T helper to T suppressor cell) ratio both in peripheral blood and the treated mice spleen. The spleen weight, phagocyte counts and phagocytic activity were also elevated in the treated group. In addition, Cs-Cr could protect T helper cells from the immunosuppressive effects of prednisolone acetate and cyclophosphamide. These results further substantiate the fact that Cs-Cr is an immunoregulator/biological response modifier of cellular immunity and may be potentially useful in handling immunodeficient or immunosuppressed patients.

Experimental and clinical trial of albendazole in the treatment of Clonorchiasis sinensis.

Abstract: Rats and dogs experimentally infected with Clonorchias sinensis metacercariae were treated orally with albendazole. Necropsy done seven days after treatment revealed that the worm reduction rates were 83.6% and 96.8% respectively. Clinically, 131 patients were treated with 3 different dosage regimens in 3 study groups. In patients receiving 5 mg/kg b.i.d. for 7 consecutive days, the stool egg negative conversion rates 1-month and 6-month post treatment were 90% and 92.6%, while in patients receiving 10 mg/kg b.i.d. for 7 consecutive days the rate were both 100%. In another group of patients receiving 10 mg/kg b.i.d. for 3 consecutive days, the 1-month and 3-month average stool egg conversion rates after treatment were only 40.0% and 28.3% respectively. The side reactions of albendazole were mild and transient. The liver and renal function tests, electrocardiography and blood and urine examinations showed no remarkable changes before and after treatment. The therapeutic effect of albendazole is comparable to praziquantel. It has the advantage of clearing various intestinal helminthic infections simultaneously, very low toxicity, excellent tolerance and relatively low cost, though its treatment course for clonorchiasis needs 7 days.

Disseminated penicilliosis marneffei in China. Report of three cases.

Abstract: Three cases with disseminated Penicilliosis marneffei (PSM) are reported. They are all natives of Guangxi Zhuang Autonomous Region. Among them, 2 died and 1 remains alive. Their clinical features were characterized by multiple organ involvement, multiple subcutaneous abscesses, inflammatory papules, nodules and pustulae, and enlargement of superficial lymph nodes with chills, fever, anemia and leukocytosis. The mycology and histopathology of PSM are also discussed. The authors propose that the medical profession in Guangxi should be vigilant against the disease and reduce the mortality by early diagnosis and treatment.

Detection of rotavirus antigen in tracheal aspirates of infants and children with pneumonia.

Abstract: Clinical manifestations of respiratory tract infection often precede or coincide with rotavirus gastroenteritis in infants and children. To investigate the possible association between respiratory tract manifestations and rotavirus infection, the authors determined human rotavirus (HRV) antigen and respiratory syncytial virus (RSV) antigen in tracheal aspirates of 58 children with clinically diagnosed pneumonia by enzyme-linked immunosorbent assay (ELISA) and immunofluorescent antibody techniques. HRV antigen was detected in 16 out of the 58 cases (27.6%) and RSV antigen was found positive in 27 cases (46.5%). In four cases both HRV and RSV antigens were detected. The results of our study suggest that rotavirus may occasionally by one of the etiologic agents of acute lower respiratory infections of infants and children and that rotavirus infection may be transmitted via respiratory route. However, further extensive studies are needed for confirmation of the association between rotavirus and respiratory tract infection.

MRI and myelography in the diagnosis of lumbar canal stenosis and disc herniation. A comparative study.

Abstract: We studied the diagnostic accuracy of magnetic resonance imaging (MRI) and the possibility of its substitution for myelography in 78 patients with lumbar canal stenosis and/or disc herniation, who had myelography and MRI examination. The diagnostic results of the two methods were compared respectively with those of operation, showing no statistical significance (coincidence rate 88.5% vs 92.3%, P greater than 0.05). We conclude that MRI could clearly reveal the pathological changes and anatomical relations of lumbar structures without invasive and radioactive damages, and that with the improvement of operative technique, better understanding of images, and reduction of cost, MRI is likely to replace myelography in the future.

Localization of functional projections from corpus callosum to cerebral cortex.

Abstract: In 30 patients with intractable generalized epilepsy treated with cerebral commissurotomy, the corpus callosum was stimulated intraoperatively at a 1 cm interval with electric current, and evoked potentials (EPs) were recorded from different areas of the brain for determining the distribution patterns of functional projections from the corpus callosum to the cerebral cortex. The surface of the corpus callosum in man was 12 cm long and it was divided into 12 segments (1 cm each). Stimulation of the first segment resulted in EPs only in the frontal lobe. Stimulation of segments 2-4 produced EPs mainly in the anterior, middle and posterior frontal lobe, anterior and central temporal lobe, rarely in parietal and occipital lobes. Stimulation of segments 5-8 induced EPs mainly in the frontal and temporal lobes, but rarely in the parietal and occipital regions; on stimulation of segments 9-11, EPs occurred only in the parietal and occipital regions. These results were confirmed electrophysiologically in 5 cats and anatomically in 8 cats. These data provide an anatomical basis for selective cerebral commissurotomy in the treatment of intractable epilepsy. Hence in patients with a concentration of epileptic discharges in the frontal lobe, the 4 anterior segments of the corpus callosum should be incised. Epileptic discharges in the frontotemporal region indicates that the middle segments should be incised and epileptic activities originating from the parieto-occipital regions can be treated effectively by selective section of the posterior corpus callosum (segments 9-12).

Histological classification of schistosomal egg induced polyps of colon and their clinical significance. An analysis of 272 cases.

Abstract: 272 cases of schistosomal egg induced polyps collected from mass-screening for colorectal carcinoma in Jiashan County were divided into 3 types: fibrous type (FT), mixed type (MT) and epithelial proliferative type (ET). The ET was characterized by crypt elongation, hypertrophy, variation in size, disorderly arrangement, as well as the high percentage of atypical hyperplasia (64.9%). The coexistence and transition between inflammatory reactive hyperplastic and neoplastic crypts were noticed. By HID/AB staining, sialomucins were increased in ET, CEA and PNA receptors detected by the ABC method were present in 18/20 and 6/18 of ET respectively. The mucin expression of ET was similar to that of adenomas. It is likely that a spectrum of ET, atypical hyperplasia and adenoma may exist. We suggest that the patients with ET, especially those with atypical hyperplasia, should be regarded as "risk group", and close follow-up is needed.

Mechanism of action of arginine vasopressin on acute ischemic brain edema.

Abstract: The purpose of this experiment is to study the role of arginine vasopressin (AVP) in acute cerebral ischemic edema in Mongolian gerbils. The results show that intracerebroventricular injection (ICV) of AVP exacerbates acute ischemic brain edema, while ICV of AVP antiserum significantly decreases the ischemic brain edema. Nimodipine (calcium antagonist) cannot block this role of AVP in brain edema. In addition, the cortical Na(+)-K+ ATPase activity is significantly decreased, while the cAMP content of ischemic cortex and hypothalamus and the cGMP content of the hypothalamus are markedly increased after AVP ICV. These suggest that AVP may play an important role in the pathophysiologic process of ischemic brain edema by inhibiting the Na(+)-K+ ATPase activity of the cerebral cell membrane and the AVP receptors mediated by cAMP and cGMP.

Epidemiologic investigation on an outbreak of hepatitis C.

Abstract: An outbreak of hepatitis in plasma donors occurred in a village of Hebei Province in the period of September to October 1985. The morbidity rate was 40.0% (26/65) in the plasma donors, which was significantly higher than that in whole blood donors (1/88) and in persons who were not blood donors (1/400). One to one paired survey was carried out, and the incidence was 46.4% (26/56) in the plasma donors, while there were no such outbreak in the control group. The distribution of cases showed positive correlation with the number of plasma donors from the production brigade. No secondary infection was found in their families. The peak of outbreak was about 2 months later than the peak of plasma donation. 26 cases of hepatitis in plasma donors all showed negative results for anti-HAV IgM, HBsAg, anti-HBC IgM, anti-CMV IgM and anti-EBV IgM. Sera of 25 cases were selected and sent to CDC, USA to confirm with Chiron C100 reagent. 24 cases were anti-HCV positive. This outbreak of hepatitis was demonstrated to be related to cross contamination during plasma donation.

Digital replantation. A ten-year retrospective study.

Abstract: Eight hundred and two digits (592 complete amputation and 210 incomplete amputations) of 549 patients were replanted. The male to female ratio was 3:1 and the age range 1-63 years. 728 digits survived and 74 digits failed. The overall survival rate was 90.8%. Special varieties of complicated amputation were encountered in this series: (1) distal segment replantation, 139 digits, 131 digits (94%) survived; (2) digital replantation of children, 45 cases, 78 digits, average age 3.8 years, the youngest being 1 year old, 68 digits survived (88.7%); (3) rotational avulsion amputation of thumb, 26 digits, 23 digits (88.4%) survived; (4) bilateral digit amputation, 8 cases, 44 digits amputated, 38 digits replanted, including 9 digits of a ten-digit guillotined case. All the digits were salvaged. We conclude that thorough debridement, meticulous anastomosis of blood vessels and timely management of vascular crisis are keys to high survival rate, while judicious selection of indication, proper internal fixation of bone, anastomosis of as many blood vessels as possible, attentive repair of nerves and tendons, sound rehabilitation program are important measures in improving postoperative function.

Preliminary observation of continuous albendazole therapy in alveolar echinococcosis.

Abstract: Fifteen cases of alveolar hydatid disease were treated with albendazole in the dosage of 20 mg/kg/d x 30 days for 12-60 courses. All cases were followed up 1-5 years (average 38 months) by ultrasonic scanning of liver and chest X-ray films. One patient whose hepatic lesion was converted into fibro-calcific after treatment was apparently cured. Twelve patients were symptomatically improved: jaundice (4 cases) and hemoptysis (2 cases) disappeared, with reduction in size of lesions in the liver and lung. Two patients in the late stage of disease with huge and extensive nodular masses in both lobes of the liver were not improved. Evidently, albendazole is effective in the treatment of alveolar hydatid disease. Early diagnosis and early treatment are to be emphasized.

Renal metastases of choriocarcinoma. A clinicopathological study of 31 cases.

Abstract: From 1949 through 1978, 31 patients with renal metastasis were diagnosed in a total of 448 cases of choriocarcinoma admitted to our hospital, giving an incidence of 6.9%. Renal metastasis was invariably preceded by pulmonary metastases and usually accompanied by other visceral metastases, indicating that renal metastasis is the result of dissemination of tumor cells secondarily from lung metastasis through the general circulation and should be categorized as arterial metastasis. Pyelogram is useful in the presence of medullary invasion by the tumor. Renal metastatic tumors are very sensitive to chemotherapy. Good response to chemical agents may be due to high drug concentration attained in the kidney tissue during excretion. Since successful treatment of renal metastasis by chemotherapy alone may be obtained, patients can be spared a major operation without jeopardizing the prognosis.

Primary ovarian pregnancy. Report of fifteen cases.

Abstract: From June 1973 through November 1988, fifteen cases of ovarian pregnancy were admitted to the Shanghai First People's Hospital. All these cases met the four criteria for the diagnosis as listed by Spiegelberg. The incidence of ovarian pregnancy as compared to those of normal and ectopic pregnancy are 1:3 179 and 1:28.1, respectively, which are higher than foreign data reported. Ovarian pregnancy is quite similar to tubal pregnancy in clinical manifestations. Etiological analysis does not reveal any close relationship with inflammation of the female genital tract. However, application of IUD increases the risk of ovarian pregnancy. The principle of management is wedge resection of the diseased ovary.

CT-guided stereotactic evacuation of hypertensive intracerebral hematoma.

Abstract: From January 1986 to June 1989, the CT-guided stereotactic evacuation was performed in 38 cases of hypertensive intracerebral hematoma with satisfactory result. 24 patients were male and 14 female. The age ranged from 37 to 78 years, with an average of 55. 24 cases had their hematoma in internal capsule, 7 in cerebellum, 5 in subcortex, and 2 in brain stem. The interval between the occurrence of hemorrhage and evacuation of hematoma was 24 hours or less in 18 cases, 2-3 days in 14 and 4-7 days in 6. The volume of hematoma was estimated by CT scanning being more than 100 ml in 6 cases whereas much less in 2 cases of the brain stem.

A serological study of hepatitis C infection in plasmapheresis donors.

Abstract: An epidemic of parenterally transmitted non-A, non-B hepatitis (PT-NANBH) occurred in plasmapheresis donors in Guan County, Hebei Province, China, in 1985. PT-NANBH was diagnosed by epidemiological studies and serological exclusion of HAV, HBV, CMV and EBV infections. Recently, 163 sera samples of 108 patients with PT-NANBH and 65 sera samples of 49 cases with elevated alanine aminotransferase (ALT) levels collected during the epidemic were tested by anti-HCV EIA (Chiron C100). The positive rates of anti-HCV in these two groups were 89.8% (97/108) and 93.9% (46/49), averaging 90.8%. The figures increased with the course of illness and persistance of ALT elevation, i.e., 17.6% and 55.6% within 1 month, 88.9% and 87.5% at 6 months and 100% and 100% after 2 years. Five patients with PT-NANBH and 1 with elevated ALT levels were followed up for 3 to 4 years. We demonstrated that anti-HCV remained positive after the disease had resolved and ALT levels had normalized.

Phosphorylated neurofilament epitopes in the achromasic neurons of corticonigral degeneration.

Abstract: By employing monoclonal phosphorylated neurofilaments antibody, we studied the abnormally pale-staining neurons in 3 cases of corticonigral degeneration by the avidin-biotin immunoperoxidase method. For comparison, the central chromatolysis in anterior horn cells secondary to cervical spine fracture and "ballooned" neurons in a case of Pick's disease and a case of Alzheimer's disease were studied with similar procedure. Achromasic neurons in the case of corticonigral degeneration and ballooned neurons in Pick's disease and Alzheimer's disease showed positive immunostaining, while neurons with central chromatolysis secondary to axonal injury did not. Our observations show that the achromasic neurons in corticonigral degeneration contain phosphorylated neurofilaments which share common antigenic characteristics with ballooned neurons in Pick's disease and Alzheimer's disease. The absence of positive immunostaining in reactive central chromatolysis suggests that despite the similarities in appearance with the usual histopathologic stains this cytoplasmic change is pathogenetically different from that in the other neuronal disorders mentioned above.

Balloon dilation treatment of phimosis in boys. Report of 512 cases.

Abstract: Five hundred and twelve boys, aged from 5 months to 12 years, with phimosis were treated by application of a specially designed balloon catheter (patented). 1% dicaine topical anesthesia was used. 3-6 months follow-up showed that all the patients were cured. The procedure is simple, safe and much less traumatizing than the conventional circumcision. The mechanisms of balloon dilation, the age-specificity and the anesthesia were discussed.

Accelerated hyperfractionation radiotherapy in esophageal cancer. An analysis of 172 cases.

Abstract: Between February 1989 and May 1983, 172 patients with esophageal carcinoma were given radiotherapy. They were randomly assigned to an accelerated hyperfractionation group and routine fractionation group. There was no statistically significant length of survival difference between these two groups at 1, 3 and 5 years. Therefore accelerated hyperfractionation is useful for its economy of duration and cost.