慢性乙肝病毒感染的诊断和治疗研究动向—与中国学者学术探讨之我见

The infection and its management A high proportion of hepatitis B virus (HBV) infections, which lead to chronicity rather than being resolved, are infections occuring at birth or early childhood[1]. Despite successful vaccination programs, the number of chronic carriers increases worldwide. Hepatocellular carcinoma (HCC) develops late in the course of a chronic infection, with its concomitant overall decrease in viral replication. However, stages associated with a particularly high risk to develop cancer are not described to this date. A still attractive model for the progression of infection points to a persistence of hepatocytes that contain chromosomally integrated, as well as free viral DNA, over hepatocytes containing only free replicating DNA[2]. Specifically, it is suggested that the process of integration depends on structural differences of replication complexes, whereby newly-synthesized viral DNA is rendered accessible to nucleases. Apart from integrated viral DNA, thus far identified only in tissue material, a marker characteristic of a chronic infection is still lacking. Stages of cryptic replicative or non-replicative HBV infection have been described[3], and are thought to represent either late stages of a chronic infection or cases of infection that has resolved without a preceding phase of chronicity[4].     

白三烯对马杉氏肾炎中肾小球细胞增殖的作用

大鼠马杉氏肾炎也称为肾毒性血清性肾炎（ＮＳＧＮ），其发病早期肾小球合成的白三烯（ＬＴ）升高，伴有肾小球增殖性核抗原（ＰＣＮＡ）（＋）细胞及肾小球增殖活性（ＧＰＡ）的增加。用花生四烯酸５－脂氧化酶抑制剂治疗ＮＳＧＮ大鼠，可抑制肾小球ＬＴＢ４的合成及ＰＣＮＡ（＋）细胞、ＧＰＡ的升高。用Ｘ线照射去除外周血白细胞也可抑制ＰＣＮＡ（＋）细胞及ＧＰＡ的升高。已知在ＮＳＧＮ中肾小球合成的ＬＴ来源于浸润的白细胞［１］，本研究证实肾小球白细胞衍生的ＬＴ促进ＮＳＧＮ的肾小球细胞增殖。     

超声刀在实验性腹腔镜肝叶切除术中的应用

超声刀在实验性腹腔镜肝叶切除术中的应用宗明吴孟超Ｐ．ＫｕｊａｔｈＨ．Ｐ．Ｂｒｕｃｈ我们使用ＳｏｎｏｃａＩ型超声刀（ＳｏｅｒｉｎｇＧｍｂＨ）对１０头猪施行了１９次腹腔镜下肝叶切除术，其中肝左内叶１０例，肝左外叶２例，肝右内叶５例，肝右外叶２例。手术技术...     

脑膜瘤的放射治疗

目的：回顾分析了法国巴黎Ｔｅｎｏｎ医院放疗科１９７６年２月～１９９３年１月收治的４９例脑膜瘤患考的放疗经验。材料与方法：Ａ组１５例采用完全切除术后放疗，Ｂ组１０例次全切除术后放疗；Ｃ组７例系术后复发放疗；Ｄ组为单纯放疗１７例。结果：各组１、２，３年生存率分别为，Ａ组１００％％；８０％和６６．７％：Ｂ组９０％，７５．５％和６６．７％：Ｃ组８５．７％，８３．３％和８０％：Ｄ组９４．１％，６８．８％和７２．７％。各组放疗后临床症状好转率：Ａ组６６．７％，Ｂ组５０％，Ｃ组７１．７％；Ｄ组３５．３％。１例放疗后３年发生闭经：１例左眼失明；３例死于远处转移；２例死于局部发展；７例死于其他原因。结果显示放疗在完全切除术后对临床症状改善和生存的影响无明显优于其他组的作用。结论：脑膜瘤次全切除术后应予以放疗；术后复发或手术困难的原发脑膜瘤可以行根治性放疗。各组无１例脑坏死发生。     

胃癌高发区和低发区幽门螺杆菌感染血清学调查

用血清学方法对胃癌高发区兰州地区３７８１名各年龄组健康人群进行前瞻性幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ，ＨＰ）感染调查，并与胃癌低发区广州地区的资料进行比较。结果显示：兰州地区ＨＰ总感染标化率为６１．６％，高于广州地区的４８．３％（Ｐ＜０．００１）。两者之间的差异在１０岁以下儿童，尤其是４岁以下幼儿最显著（分别为４３．２％与１９．３％，Ｐ＜０．００１）；兰州地区ＨＰ阳性率的高峰年龄段在３０～３９岁，比广州地区提早１０年以上出现，可能与胃癌高发区人群较早出现ＨＰ相关性萎缩性胃炎及肠上皮化生有关。     

中国广东汉族群体HLAⅡ类基因多态性的研究

为探讨中国广东汉族群体HLAⅡ类基因多态性，采用PCR／SSO方法，随机选择102名广东籍汉族人进行了HLAⅡ类基因的DNA分型。测定了包括HLA－DRB1，DRB3，DNB5，DQA1，DQB1和DPBI等6个基因座位的等位基因。结果：共检出23种DRB1，3种DRB3，4种DRB5，8种DQA1，12种DQB1和12种DPB1基因。该人群的HLAⅡ类等位基因多态性的典型性表现在HLA－DRB*1202的不寻常优势和DRB1*02单倍型的结构的高度复杂性。还发现了很高频率的一个近年才被正式命名的DP新型：HLA－DPB1*2101，并且此型具有极不寻常的DRB1*1202－DPB1*2101的连锁不平衡。为分子流行病学研究提供了资料。     

SURGICAL TREATMENT AND LATE RESULTS IN l,226 COLORECTAL CANCER CASES

1,226 cases of colorectal cancer were treated surgically between 1956-1978. 798 (65.09%) were rectal, 74.3% 0f which were located below the peritoneal reflection. Dukes C2 cases and cases with distant metastasis constituted 39.15To and Dukes' A cases 9.22%. Resectability rate was 75.1% (77.6% for rectal cancer). 32.96% of 619 cases of rectal excision had restorative resection. 84.8% 0f the combined excision for extraperi- toneal lesions in female patients were posterior pelvic exenteration. The overall operative mor- tality rate was 2.93%. Mortality rate of resec- tion was, 1.73(70 and that of rectal resection 0.8%。 and curative rectal resection 0.63%. Follow up rate was 94.13% The 5- and 10-year survival rates for rectal resection were 53.08To and 47.65%, for curative rectal resection 66.91To and 60.27To, and for Dukes' A cases 98.05% and 96.39%. The 5- and 10-year survival rates for colonic resec- tion were 59.79% and 52.18%, for curative colonic resection 72.79% and 62.06%, and for Dukes' A cases both 100%. Among factors affecting the- rapeutic results, local immunologic reaction of the host is also important, showing that the more lymphocytic infiltration in and around cancer, and the more follicular hyperplasia and sinus histiocytosis in regiona.l lymph nodes the better the prognosis. Anal preservation in radical re- section of rectal cancer and improving results in the treatment of extraperitoneal rectal cancer are discussed in detail.     

高血压病人的血浆和细胞膜中钙、镁含量与常人的比较

引言用荧光标示法或原子吸收分光光度法测定特发性高血压患者血浆或细胞内电解质代谢的改变常有报道,主要注意力集中在胞质中钙和镁的游离浓度及其与肌动球蛋白细丝的相互作用。然而,在高血压病中,有细胞信号传导改变的证据,且在增多。信号传导的开始阶段是位于胞浆外膜结构内。我们研究了血压正常者和高血压病人的红细胞膜中的钙和镁含量。膜中的钙和镁,用原子吸收分光光度法测定,按照Bradford法认为,与膜蛋白的浓度有关。病人与方法调查了38名患者。18名血压及肾功正常者作为对照,20名特发性高血压且肾功正常的患者,进行了红细…     

疟疾疗法治疗晚期肿瘤的初步报告

［目的］通过初步的临床试验探索疟疗治癌的适应证及疗效,疟疗疗程与疗效的关系,其他抗癌疗法对疟疗的影响和观察疟疗治癌的副作用及并发症。〔方法〕共选择7例晚期肿瘤病人作治疗观察对象,其中乳腺癌1例,小细胞肺癌1例,肺腺癌1例,鼻咽癌1例,胰头癌1例,卡波氏肉瘤1例,直肠癌1例。诱发人工间日疟,疗程为10～17次疟疾阵发。〔结果〕乳腺癌和卡波氏肉瘤共2例部分缓解（PR）,其他5例无效。但值得注意的是2例有效者在疟疗前近期均无化疗史（或不超过一个疗程的化疗史）,而5例无效者均在疟疗前近期有一个疗程以上的化疗史或放射性同位素注射治疗史。未发现疟疗疗程与疗效之间有任何关系。并发症均不严重,1例在疟疗中并发支气管哮喘,另1例并血小板减少,经相应处理均迅速恢复。［结论］初步提示疟疗可能对无化疗史和放射性同位素注射治疗史的某些晚期肿瘤部分缓解,但需进一步研究。根据放疗的热增敏效应提议今后应探索疟疗与放疗相结合的联合疗法。