Volume 93  ·   Issue 02  ·  1980

A newly devised staging system for carcinoma of the stomach based on the TNM classification is suggested. To test the staging concept, 301 consecutive patients with stomach carcinoma followed up at least 5 years after gastrectomy are evaluated statistically by the chi-square test. The problems in categorizing the T3N0M0, T1N1M0, T4a, T4b and N3 stages are discussed briefly.

The authors have carried out a series of study, including the cell-mediated immunity to HBsAg and liver specific protein (LSP), lymphocyte subpopulation and rosette inhibitory factor among 113 cases of viral hepatitis B of various types. The cell-mediated immunity to HBsAg and LSP was more intense in acute and chronic active hepatitis, but less so in chronic persistent hepatitis and asymptomatic carriers. The cell-mediated immunity varied with anti-HBs, and the higher the cell-mediated immunity to HBsAg, the lower the titer of serum HBsAg. The nonspecific T cell functions including E rosette lymphocyte count, positive rosette inhibitory factor (RIF) and delayed cutaneous reactivity varied inversely with the specific cell-mediated immunity and anti-HBs. The authors believe that type B hepatitis iS a disease of immune network imbalance in which T cell defect must play the leading role. The defect of T cell function in chronic active hepatitis and fulminant hepatitis is Predominantly due to RIF.

Two cases of extensive osteolysis of the femur treated with artificial endoprosthesis are reported. This method was used to preserve the diseased limb. Biopsy revealed in both cases typical change of fibrous-osteodysplasia with pathologic fractures. All the diseased femoral portions were dissected. The artificial femur comprised joint made of titanumalloy and polymer material. Follow-up 1-3 years after operation showed good results in both patients.

On the basis of the study of 210 cases of sliding esophageal hiatus hernia (SEHH) and normal esophagogastric regions in 40 subjects, 4 roentgenologic diagnostic features have been suggested: supraphrenic hernial sac, the gastric mucosa appears supradiaphragmatically, the inferior esophageal sphincter is raised and contracted and esophagogastric ring. It is important to differentiate a small hernial sac from the phrenic ampulla. After the peristaltic wave reaches it, the top of the phrenic ampulla becomes pointed, next it flattens and rounds and then the whole phrenic ampulla contracts centrifugally and finally disappears. The entire course is continuous and the time from becoming flat-topped to the disappearance of the ampulla is 2-4 seconds. The ampulla is always smaller than 5 cm. However, there is often no relation between the contraction of the hernial sac and esophageal peristalsis, the hernial sac often existing for more than 5 seconds and its diameter being larger than 5 cm.

This study reveals that immune RNA (IRNA) extracted from lymphoid tissue of HBsAg immunized sheep can specifically convert immunologically incompetent leukocytes of chronic HB patients into competent leukocytes as was done in 15 of 20 patients. Prior treatment of IRNA with RNase abrogated this conversion, indicating the RNA nature of IRNA. It is hoped that our experimental results may serve as useful reference for clinicians who are interested in treating chronic hepatitis patients with IRNA. We are of the opinion that in order to verify the specificity of the IRNA enWloyed, it is necessary to prepare extracts of lymphoid tissue from normal animals as well as from animals immunized with other viruses. Besides, there were 5 chronic hepatitis patients in our study whose leukocytes failed to acquire adoptive irTrmunity after incubation with IRNA. Whether or not this defect in conversion infers an immunologic tolerance merits further study.

Particles closely resembling hepatitis A virus (HAV) are isolated from 6 of 10 patients studied and high titered anti-HAV serum is produced which is interesting and may be of practical importance for diagnosis purposes. Further studies for more definite identification of the particles is being persued.

A general survey of 4 million inhabitants was made in Shanghai to ascertain the prevalence rate of mental disease during 1972-1973. It was found that the average prevalence rate of mental disorder was 7.28‰, the urban districts being 7.86‰ and rural area 6.67‰. A 3-level scheme of organization for mental disease has been established and shows encouraging results.

Of 21 cases of cryptococcal meningitis encountered in a 5-year period, 16 were treated with garlic alone and 5 with garlic and other drugs. Among the 16 cases, 6 were cured and 5 improved, giving an effective rate of 68.75%. Preliminary experimental studies of the mechanism of the pharmacologic action of garlic show that it may have fungistatic action and improve the patient's immunologic function. It is also obviously cheap, plentiful and causes no major side-effects.

Since 1971 our clinic has been reorganized into a joint anti-lung cancer and anti-tuberculosis clinic with the cooperation of all the district's hospitals and the Shanghai Chest Hospital. Through mass mobilization and investigation early cases are discovered. The network organizes the health personnel better and those who need it get specialized training and methods of early diagnosis are improved. The district's 5-year survival rate has been increased to 8.46%.