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.

Die im Experiment durch hohe Blutcholesterinwerte erzeugte Fütterungsatheromatose beim Kaninchen ist mit der sogenannten Atheromatose des Menschen vergleichbar. Durch Einwanderung von Monocyten in den Subendothelialraum und spätere Migration von monocytogenen Schaumzellen in die Blutbahn zeichnet sich eine Lipidclearance ab. In den intramuralen Coronargefäßen des Kaninchens entsteht durch Fettinsudation oder Perfusion eine polytope polyclonale Proliferation von glatten Muskelzellen.

An 10 Sektionsfällen mit einem generalisierten Tumorbefall wurden Brust und Lendenaorta mit paraaortalen Lymphknoten „gerollt“ und sodann histologisch untersucht. Die arteriosklerotischen Veränderungen in der Lendenaorta waren stärker als diejenigen im Bereiche der Brustaorta. Durch Okkupation von paraaortalen Lymphknoten sind die in der Adventitia gelegenen Lymphgefäße infolge einer Lymphbahnblockade stark dilatiert. Die ungenügende Lymphdrainage ist Ursache des Intimaödems bei der Frühform der Arteriosklerose. Darüber hinaus ist die gestörte plasmatische Perfusion für die Akzentuierung der arteriosklerotischen Wandveränderungen verantwortlich. Die seinerzeit von Doerr konzipierte Perfusionstheorie zur Entstehung der Arteriosklerose wird somit als pathogenetisches Prinzip erneut bestätigt.

Using direct extracellular lead the electrical activity of toad’s sinus venosus may he recorded by electrocardiograph. Ordinarily two waves could be recorded in each cycle and were named wave N and wave P respectively. Intracellular recording indicates that wave N reflects the electrical activity of the pacemaker cells while wave P reflects that of the working cells situated in sinus venosus or atrial cells.

We have observed the effect of high potassium, high potassium plus calcium on the activity of sinus venosus. The results indicate that high potassium evokes intrasinal or sinoatrial block and thus slows the cardiac rhythm which can be antagonized by high calcium

Wegen der verborgenen Lage der suprahepatischen V. cava inf. stellt die Anastomosierung derselben die schwierigste Anastomosierung dar. Von 1977 bis 1981 wurden in unserem Institut 10 orthotope Lebertransplantationen durchgeführt, wobei sich die Resultate der Anastomosierung in 4 Grade einteilen lassen: völlig befriedigend (5 Fälle), ziemlich befriedigend (2 Fälle), unbefriedigend (2 Fälle), und fehlerhaft (1 Fall). Bei dem letzteren Fall wurden die Ränder des Herzbeutelrests der Spenderleber zuerst fälschlicherweise zur Anastomosierung benutzt; dadurch wurde die Vitalität der Transplantatleber sehr beeinträchtigt. Zur Vermeidung dieses technischen Fehlers und verschiedener Arten von Blutungen wurde eine verbesserte Technik entwickelt, deren wesentliche Punkte hier ausführlich erörtert werden.

Die zerebrovaskulären Erkrankungen waren eine der Haupttodesursachen in der Provinz Hubei mit einem Prozentsatz von 7,4% der Gesamttoten. Die Mortalität war 61,1/10⁵, sie war höher in den Städten mit einer Mortalität von über 100,0/10⁵ und somit die häufigste Todesursache in den Städten. Die Mortalität auf dem Lande war unterschiedlich, sie war am niedrigsten im Verwaltungsbezirk Enshi mit einer Mortalität von 26,6/10⁵. Die Höhe der Mortalität hängt von der geographischen und topographischen Verteilung ab. Sie war niedriger in gebirgigen und höher in hügeligen und flachen Gegenden. Sie war niedrig bei den Altersgruppen unter 30 Jahren, steigerte sich aber auf das Doppelte in jeder nächsten Altersgruppe. Die Steigerungstendenz der Mortalität der einzelnen Altersgruppen in den Städten und auf dem Lande war ähnlich, aber der Steigerungsgrad war verschieden. Durch Ausschluß der zerebrovaskulären To desursache würde die Lebenserwartung um 1,5 Jahre verlängert.

In this paper mortality rate and major causes of death among inhabitants of Macheng County were analysed statistically. Heart diseases rank first (21.44%), and cerebrovascular diseases second (14.81%) among all causes of death. The next three in order were respiratory diseases (13.86%), tuberculosis (10.99%) and malignant tumor (10.85%). The mortality rate from these five main diseases together constitutes 71.95% of the total mortality rates. They cause 160.24/10⁵, 110.96/10⁵, 103.63/10⁵, 82.12/10⁵ and 81.12/10⁵ deaths respectively. The death rates from these five main diseases were also analysed statistically according to sex, age and geographical distribution. The results so obtained provide a scientific basis for planning the prevention of diseases.

Intraerythrocytic K⁺ and Na⁺ were determined to study their significance in diagnosing and treating digitalis intoxication.

77 patients studied were divided into 4 groups: (1) 14 in toxic group; (2) 13 in digoxin treatment group; (3) 20 in combined group; and (4) 30 normal persons as controls.

The values of [Na⁺]_i and [Na⁺]_i/[K⁺]_i were much higher in toxic group than in nontoxic group. [Na⁺]_i was 16.91 in toxic group and 12.64 in nontoxic group, whereas [Na⁺]_i/[K⁺]_i 0.209 in toxic group, and 0.147 in nontoxic group (P < 0.01). They dropped remarkably 1 week after discontinuance of digitalis. [Na⁺]_i dropped to 10.05, and the ratio of [Na⁺]_i/[K⁺]_i to 0.113. The same alterations appeared in combined and digoxin treatment group, as distinct from controls.

The mechanism of toxic response of digitalis pertaining to intraerythrocytic electrolytes was discussed, and the guiding parameter in treating digitalis intoxication was also suggested.

The dynamic observation of [Na⁺+]_i, [K⁺]_i; and [Na⁺_i/[K⁺]_i for diagnosis and treatment of digitalis intoxication were advised.

Glutaraldehyde-treated bovine pericardial tubes were implanted to replace the abdominal aortae of 16 dogs, the time of observation being 1 day to 190 days, with an average of 63 days. Three of the 16 grafts failed, of which 2 cases developed thrombosis and one developed pseudoaneurysm associated with infection of the graft. Thirteen of the 16 grafts were patent, with a patency rate of 81.3%. By means of filling-pressure test of the specimens, measurement of relative tensile strength of the anastomoses and gross and microscopic examinations, we found that none of the 13 patent grafts had dilatation, all anastomoses healed quickly and firmly and no immunoreaction was seen histopathologically. This experimental result suggests that the pericardial tube is a hopeful vascular substitute for reconstruction of artery.

Using the echocardiographic technique before and after oxygen inhalation, we observed pulmonary and aortic valves of 30 normal newborns within 24 hrs after birth. Right ventricular pre-ejection period/ right ventricular ejection time ratio (RVPEP/RVET) and left ventricular pre-ejection period/left ventricular ejection time ratio (LVPEP/LVET) were measured from the pulmonary and aortic valve echocardiograms respectively, and then the R/L, i.e. (RVPEP/RVET): (LVPEP/LVET) ratio, was also calculated. According to Riggs’ and Spooner’s equations^{[3, 4]} we calculated the pulmonary arterial diastolic pressure (PADP), the pulmonary arterial resistance (PAR) and pulmonary/systemic resistance ratio (PAR/RS). The findings obtained suggest that the echocardiographic observations on pulmonary and aortic valves, as a method for non-invasive determination of PADP, PAR and PAR/RS ratio, can be used to differentiate functional vasoconstrictive pulmonary hypertension from organic pulmonary hypertension, if the observation of RVPEP/RVET ratio is repeated after inhalation of high concentration of oxygen.

The results of investigation by M-mode, two-dimensional and contrast echocardiography in 41 patients with ASD are reported. The differences in the heart shape, the dimensional ratio between the right and left ventricles, and the direction of the interventricular septal motion of the patients with ostium primum defect, ostium secundum defect and trilogy of Fallot are described. The characteristics of left-to-right, bi-directional and right-to-left shunts at the atrial level in contrast echocardiography and their relation to hemodynamic changes are also mentioned. The clinical value of echocardiography in detection of ASD and problems relating to its improvement are discussed.

The haemodynamic changes of 30 hypertensive patients treated with rhomotoxin were studied with mechanocardiogram. Both PEPI and PEP/LVET were apparently increased in our patients, indicating that the myocardial compliance of the hypertensive patients was reduced and their cardiac function was abnormal to a certain extent. Rhomotoxin reduced the cardiac afterload by lowering the blood pressure (from 192±26/114±14 to 143±25/88±11 mmHg) and slowing the heart rate (from 76±13 to 58±10 beats/min) significantly. Its effects on cardiac phases were mainly to shorten QA₂I, LVETI and PEPI and to prolong SFW, while other parameters such as PEP/LVET, A/EO, EF and Vcf were unchanged. Thus, as the blood pressure of the hypertensive patients was lowered to a significant therapeutic level by rhomotoxin, the left ventricular ejection would be enhanced without depressing myocardial contraction and its pump function. Furthermore, the myocardial oxygen consumption was markedly reduced (P < 0.001), thus rhomotoxin would help to improve the cardiac function in hypertensive patients.

Eine von uns entwickelte Methode zur Bestimmung der Compliance der Arteria pulmonalis (C_{p a}) wird dargestellt. Aus der Höhe der systolischen Welle in der dZ-Kurve des Impedanz-Pulmonal-Rheogramms und aus der Druckamplitude der Arteria pulmonalis kann man C_{p a} berechnen: C_{p a} =H/dP x 124,37+2,56 (ml/mm Hg).

Bei “Beine hoch” und unter Belastung fällt C_{p a} ab, weil der Anstieg des Schlagvolumens dabei zur Vergrößerung des dP führt. Bei Patienten mit pulmonaler Hypertonie vergrößert sich dp und vermindert sich H infolge der Erhöhung des Lungengefäßwiderstandes und von P_{p a}; dadurch nimmt C_{p a} ab.