Volume 99  ·   Issue 02  ·  1986

EAR method is a newly devised operation consisting of proper resection of the tumor, removal of tumor tissue as much as possible from the resected specimen extracorporeally (excision-E), soaking the residual shell in 95% alcohol (A) for half an hour, allowing alcohol to permeate into the bone to kill the microscopic tumor cells, and finally replantation (R) of the bone shell in situ, the cavity being filled with chips of allografts or bone cement and fixed with screws or plate. The joint ligaments were reattached with heavy silk sutures. Early joint mobilization was necessary for better motion in the postoperative period. Seventeen patients with aggressive and malignant bone tumors (excluding osteosarcoma) were treated with this method and followed up from one to five years, with an average of three years. Two-thirds of the patients had good results. Experimentally, it is proved that alcohol can kill tumor cells completely and does not interfere with osteogenesis which occurs as a gradual substitution of dead bone by newly formed bone. Although the joint cartilage degenerates, it will be replaced by newly formed fibrocartilage, which is responsible for the preserved joint function.

One hundred and thirty one cases of small intestine tumors are reported. 60 were benign, leiomyomas being the commonest and lipomas the second. In the malignant cases, lymphomas were the commonest, carcinomas the second. There was one rare case of jejunal primary squamous cell carcinoma proved by electron microscopy. 1,024 of primary tumors of small intestine from other Chinese sources and 1,410 from the foreign literature were collected and the incidence, pathologic type, location etc. compared with the authors' series.

Sixty-three patients with disability secondary to poliomyelitis underwent muscle transfer for the paralyzed gluteus muscles. The operations included transfer of the erector spinae and tensor fasciae latae muscle for the gluteus maximus (50 times) and transfer of the external oblique muscle for the gluteus medius (59 times). Follow-up results of 42 patients or 43 operations showed that muscle power increased by 1.28 grades on an average in 84.3% of the patients after the transfer of the erector spinae and tensor fasciae latae, and an average of 1.68 grades in 89.1%。 of the patients after external oblique transfer. The surgical indications and important points of the operation are discussed.

The Denver developmental screening test (DDST) was a simple method of screening for evidences of slow development in infants and pre-school children. It is simple to administer, easy to score and interpret, and useful for repeated evaluation of the small children. In order to investigate the feasibility of this method in the wide areas of our country, the collaborative study group decided to extend the study on a larger scale. From April 1980 to April 1982, DDST was carried out for 6,886 children in six cities (Beijing, Xian, Harbin, Shenyang, Dalian and Jiamusi) of North China. All children sampled were healthy and those with high risk of developmental abnormalities were excluded. AlI tests were based on one plan with the same equipment according to the original methods of WK Frankenburg. All the original test items were used except for one in the language sector: "using plurals" because there is no distinction between singular and plural of nouns in Chinese language. The percentile of children in each age group who passed each item according to Probit's method was calculated (25%, 50%, 75% and 90% respectively). The reliability among the examiners ranged from 81-100% with a mean of 93%. The validity was 81%. Generally, these data, were similar to Denver's (78.4-87.0% of items). The developmental scale obtained from this restandardization can be used for children in North China.

The pooled sera of inbred C57BL/6 mice infected with Schistosoma japonicum, the antisera against gut-associated antigen (GAA) from artificially immunized rabbits (RAGAA20) and the antisera against soluble egg antigen (RASEA) purified by immunoaffinity chromatography were tested with cercaria-stuck-slides, adult worm sections and liver-egg sections by immunohistochemical studies with peroxidase-linked protein A (PPA method). In mice anti body against eggs was detected before oviposition. Eggs containing late developmental stage of embryo started to secrete SEA 37 days after infection when the titer of the antibody against eggs reached 1:256. GAA20 and SEA were proved to be at the same location within mature eggs, and RAGAA20 only reacted with eggs exuding SEA. RASEA reacted strongly with the membrane of cercaria. The results showed that S japonicum SEA shared its antigens with GAA and membrane-associated antigens (MAA). GAA might play a role of presensitizing in egg granuloma formation.

Primary sclerosing cholangitis (PSC) in children is very rare. We encountered five cases from May 1981 to April 1984. They were diagnosed by ultra-sonography and percutaneous transhepatic cholangiography (PTC) combined with clinical features and laboratory findings and four were confirmed surgically and histologically. We suggest that one must keep PBS in mind whenever obstructive jaundice is found in children and be differentiated from other diseases with obstructive jaundice. As soon as the diagnosis is made, operation should be performed on those with localized lesion. For diffuse cases, antibiotics, cholagogics, and prednisone should be given immediately. In this series, one patient died of hepatic failure postoperatively, the other four were free from jaundice or other symptoms, who have been followed up for 3-26 months.

In this study we attempted to evaluate the effects of the external factors, such as the interval between abortion and preparation of the fetal liver cell suspension, the temperature, the instruments used and isolation procedure, on hemopoietic proliferative activity of human fetal liver by incorporation of tritiated thymidine (3H-TdR) and colony forming cells in culture (CFU-C). Besides, the suitable conditions were suggested for preparing the single fetal liver cell suspension.

This paper reports one case each of Type I diabetes and chronic lymphocytic thyroiditis both associated with dermatomyositis. The pathogenesis shows the same patient successively suffering from two diseases which may be presumed to be related to autoimmune disease. Both patients showed transient immunologic hyperfunction, IgG and IgM being elevated, ANF positive and micros Ab 1:1,280. Prednisone is good for chronic lymphocytic thyroiditis associated with dermatomyositis, but it is harm ful in diabetes with dermatomyositis complicated by ketoacidosis as prednisone poisoning may occur, Tripterygium wilfordii, azathioprine and insulin were used to treat the dermatomyositis with diabetes satisfactorily.

Ascaris lumbricoides is in world-wide distribution. In an endemic area, biliary complication is common in adults as indicated in 54 patients. From June 1981 to August 1984, the 54 patients were diagnosed as having biliary ascariasis by endoscopic retrograde cholangiography (ERC) or ultrasonography (USG). In 14 patients (1981-1983), an endoscopic snare was used to remove the worms from the main bile duct under radiological control, with a success rate of 7l.24%. In the rest 40 patients (1984), real time ultrasonic examination was used instead of ERC for diagnosis and treatment-monitoring of this disease, with a success rate of 92.5%. All patients were treated in the outpatient department without significant complications. We conclude that the endoscopic worm removal combined with ultrasound monitoring is a quick, reliable and safe method for the treatment of biliary ascariasis.

11,734 cases of gastric cancer treated during the years of 1971-1981 were studied retrospectively. Of 9,602 cases underwent various operations, 5,829 cases had resection, a resectability of 60.7%. The prognosis for the young patients under 30 years was remarkably poorer than for those above 30 years. Early diagnosis as well as a more rational and effective surgical treatment is emphasized.