This paper presents the results of a survey of hemoglobinopathies in 1137 persons in Hubei Province. Among them 4 cases of abnormal hemoglobin were found and the frequence was 3.52% According to the clinical and laboratory data and especially the structural analysis of the hemoglobin variant, 3 cases were proved to be HbE, HbGTaibei and HbGCoushatta respectively. In the family with HbGCoushatta 2 members were found to be homozygotes. HbGCoushatta and HbGTaibei are described in detail in this report.
Since 1972 we have performed PCDV (pericardial devascularization) on 55 portal hypertension patients, among whom 15 underwent various shunt or nonshunt operations previously. There were 5 deaths postoperatively. Of the 50 patients discharged from the hospital 42 could be followed up. Recurrence of bleeding was seen in 8(19%) and two of them died, the lethality being 4.8%. 14 patients in this group were reoperated on, and all were found surviving on follow-up. Among them only one had slight melena.
In performing PCDV we have found that the coronary vein has a HEB (high esophageal branch) which runs forward and upward at the level of visceral surface of left lateral lobe of the liver and receives blood from the muscular layer of the esophagus about 4–5 cm above the cardia. It is the crux of PCDV to disconnect the HEB thoroughly during this procedure.
Pre and post-PCDV portal venography and measurement of portal vein pressure show the existence of the abnormal blood flow in the HEB and the importance of complete interruption of the said branch. Moreover, the portal blood perfusion of the liver is enhanced after operation. These hemodynamic changes have led us to believe that PCDV is quite a reasonable and practicable procedure.
The hemodynamic changes of THBF (total hepatic blood flow), portography after PCDV (pericardial devascularization) and the cephalad portasystemic collaterals in the bleeders are reviewed. In 78 cases with bleeding varices, including 24 re-bleeders, the occurrence of coronary varices (88.46%) is much higher than that of short gastric varices (34.61%). There is a very significant difference between the two (P < 0.001). In analysing the relationship between the coronary varices in portography and bleeding of the esophageal varices pre and post-PCDV, we have recognized the role of the lesser splanchnic circulation of the portal system, especially the coronary vein, in the formation of the esophageal varices and bleeding. The value of THBF is 13.49 ± 0.84 (SE) m1/min/kg preoperatively and is increased to 15.96 ± 1.04(SE) m1/min/kg postoperatively. The postoperative value is increased by 18.31% (P < 0.01). Hemodynamically, PCDV is a rational procedure, which can not only control the variceal bleeding, but also increases hepatic blood perfusion.
Portal pressure measurements at different sites were performed in 22 patients with liver cirrhosis and in 28 control patients by a modified equipment, “Lumbal manometer”. The hemodynamic changes of portal pressure in portal hypertension and the relationship between these changes and varices formation and bleeding, especially the important role of the elevation of CVP (coronary vein pressure) are discussed. Moreover, the rationality and effectiveness of PCDV are also dealt with in this article. From the above we are led to conclude that PCDV (pericardial devascularization) is a rational procedure and is recommendable for patients with liver cirrhosis and varices hemorrhage, especially for poor risk patients.
Anhand von 100 frischen Ganzleberpräparaten wird hier zum erstenmal in China die chirurgische Anatomie des Leberhilus eingehend beschrieben. Verschiedene Varianten der Aufteilung der A. hepatica am Haupthilus werden erörtert mit besonderer Berücksichtigung der den linken paramedianen Lappen versorgenden A. hepatica media, die manchmal aus der linken, manchmal aus der rechten Leberarterie entspringt. Infolgedessen gehört der linke paramediane Lappen (Lobus quadratus) vom Stand der arteriellen Blutversorgung aus nicht immer zur linken Leberhälfte. Die linke Lebervene vereinigt sich in den meisten Fällen vor dem Eintritt in die Cava intrahepatisch mit der mittleren Lebervene, und die Vereinigungsstelle liegt im Leberinneren regelmäßig auf der geradeaus verlaufenden Verlängerungslinie des Lig. falciforme-Ansatzes. Eine Freipräparierung der linken Lebervene, welche sehr leicht zerreißt, kann eine lebensbedrohende Blutung verursachen, und die Blutungsgefahr wird durch das Vorhandensein der V. hepatica superficialis, deren topographische Lage den meisten Chirurgen leider noch nicht bekannt ist, noch erhöht. Am Hilus hepatis renalis ist die erste Reihe der kurzen Lebervenen zu finden, und die kaliberstärkste, und zugleich die oberflächlichste kurze Vene liegt gerade der rechten Nebenniere gegenüber. Wegen der extrahepatischen Lage ist eine Freilegung des Ductus hepaticus mit seinen beiden Hauptästen ohne Inzision des Leberparenchyms möglich.
Different types of fracture of the surgical neck of humerus treated by means of combined Chinese traditional and western manipulation are described in detail in this article.
60 cases of fracture of the surgical neck of humerus were treated by manipulative reduction and immobilized with small splints (made of Chinese fir bark). 33 cases were followed up for an average of 31 months. 97.33% of cases have recovered excellently. Early reduction and immobilization with small splint followed by early functional exercises are the keys to rapid and complete recovery.
After replantation of incompletely severed limbs had been performed in the thighs of the hind legs of 5 dogs, the time and form of lymphatic regeneration and its relation to the subsidence of edema were studied by lymphangiography with direct technic (group 1). Radiogram taken in the 3rd week postoperatively showed the beginning of lymphatic regeneration. In the 5th week the lymphatic trunks were completely connected and returned to normal. However, no formation of collateral lymphatic circulation could be seen. In the other 5 dogs (group 2) the femoral arteries and veins were ligated and severed instead of being re-anastomosed, and it was found that a collateral lymphatic took part in lymphatic drainage in the 1st week. With regeneration and connection of the severed lymphatics in the 3rd week, the collateral lymphatics gradually disappeared except in one case when it remained visible until the 7th week. Proof is present that the lymphatics play an important role in assisting the vein to overcome edema and to restore the normal condition of the limbs. This study offers a theoretical basis for clinical practice that there is no need to anastomose the severed lymphatics during replantation of severed limbs and other transplantation operations.
| 1. | Tetrandrine was found to decrease the contractility, ±dT/dtmax and automaticity and prolong the functional refractory period of cat papillary muscle, but it exerted no influence on its excitability. |
| 2. | The above results are in accordance with those we obtained previously in guinea pig atrium. |
| 3. | The negative inotropic and automaticitic effects indicate that tetrandrine might be a calcium influx blocker like verapamil. |
Bei diesem Fall von Malaria tertiana ist das Plasmodium verschieden von dem gewöhnlichenPlasmodium vivax. Charakteristisch für diesen Fall ist:
| 1. | Die Hyperparasitämie ist außerordentlich hoch (3, 68%), und der schwere Krankheitszustand ist wahrscheinlich durch die schwere Parasitämie verursacht. |
| 2. | Kleine Trophozoiten sieht man relativ wenige, aber Plasmodien in späten Stadien, besonders Gametozyten, sind verhältnismäßig zahlreich. |
| 3. | Die kleinen Trophozoiten sind unregelmäßig geformt, und das Zytoplasma der großen Trophozoiten ebenfalls. Bei der Multipel-Infektion ist das Zytoplasma von nebeneinanderliegenden Plasmodien miteinander “vereinigt”. |
| 4. | Die Schwellung und Abblassung der Erythrozyten hängen von dem Stadium und der Zahl der eingedrungenen Plasmodien ab, überdies ist die Schüffnersche Tüpfelung nicht zu sehen. |
Obgleich diese Charakteristika nicht über den Bezirk der Gattung desPlasmodium vivax hinausreichen, weisen die Besonderheiten der Morphologie und der klinischen Erscheinungen darauf hin, daß dieses Plasmodium in bezug auf Protozoologie Epidemiologie und Symptomatologie weiter erforscht werden sollte.
Aufgrund von Urin-FDP-Bestimmungen bei verschiedenen Glomerulopathien im Kindesalter stellten wir fest, daß Urin-FDP beim nephrotischen Syndrom für die Typeneinteilung (Lipoid-oder nephritische Nephrose), die Krankheitsbeurteilung, die Beurteilung der therapeutischen Beeinflußbarkeit und für die Prognose von großer Bedeutung ist. Auch bei akuten Nephritiden spielt FDP bei der Krankheitsbeurteilung eine ziemlich große Rolle. Deshalb schlagen wir vor, bei jeder Glomerulopathie Urin-FDP in regelmäßigen Abständen zu bestimmen.
A rare case of orbital chemodectoma is reported in this paper. The old female patient had been admitted to our hospital, the tumor was removed surgically and diagnosis was confirmed by pathological findings. Here, the clinical features and pathological findings are thoroughly described and discussed.