Clinical anatomy of the subcutaneous veins in the dorsum of the hand

Ninety adult upper extremities from human cadavers were used to study the patterns of the subcutaneous veins in the dorsum of the hand, with careful dissection and measurement under magnification. In our series, the distribution of the veins was not symmetrical in the dorsum of the hand. In 83.3% of the cases, the veins were arranged in two groups, radial and ulnar, above the transverse midline of the dorsum. The area between these two groups, corresponding to the proximal halves of the second metacarpal bone, the second intermetacarpal space and the third metacarpal bone, might be called "vein lacking area". Crossing branches of veins were found in all cases. There were on average three crossing branches in each case, and their internal diameters were 0.9 +/- 0.2 mm. This study established that the subcutaneous veins in the dorsum of the hand are arranged in two layers. They communicate freely with the veins in the palmar aspect through the intermetacarpal spaces. The average number of perforating branches was 3.9, and their internal diameters were 1.0 +/- 0.4 mm. The perforating branch in the first intermetacarpal space was wide (internal diameter: 1.8 +/- 0.3 mm) and very constant (appearance rate: 100%). This branch may be the most important communication between the superficial and deep veins. We found the venous values in 70.0% of the perforating branches, which prevent the blood flowing from the dorsum to the palm.

Immunological status of patients with obstructive jaundice and immunostimulatory effect of arginine

Sepsis is a major factor in the high mortality and morbidity following diagnostic and therapeutic procedures in patients with obstructive jaundice. The reasons for this increased susceptibility to infection are not fully understood. We therefore observed prospectively changes in immunological status of patients with obstructive jaundice in the perioperative period and studied immunological effects of perioperative arginine therapy. The results showed that there was a significant reduction in interleukin 2 (IL-2) production, interleukin 2 receptor (IL-2R) expression and lymphocyte response to phytohemagglutinin (PHA) mitogen in patients with obstructive jaundice compared with normal controls. After operation, the immune suppression in patients with obstructive jaundice was more significant. Arginine is a known T lymphocyte stimulator. Perioperative supplement with arginine significantly enhanced the immune function of patients with obstructive jaundice, the mechanism being related to increased IL-2 production and IL-2R expression.

Regulating gene expression in transgenic animals

Regardless of the field of application, the raison d'etre of transgenic animals is to study gene regulation and function. With increasing frequency, mammalian genes are being isolated with no concomitant knowledge of their function. The human genome mapping initiative will undoubtedly produce a cornucopia of such genes. While the merit of taking a transgenic route to study genes of unknown function is axiomatic, the choices of strategies for gene regulation in vivo may not be fully appreciated. This review will address two main points: first, the targeted and regulated expression of genes, and second, the structural and functional ablation of genes.

Interleukin 2 production and its relationship with T lymphocyte subsets in patients with obstructive jaundice

Sepsis remains a major risk in the high mortality and morbidity after surgery for obstructive jaundice. The reasons for the increased susceptibility to infection are unknown. This study examined interleukin 2 (IL-2) production and the lymphocyte response to PHA mitogen in 31 patients with obstructive jaundice. Among them, 18 patients were simultaneously investigated by enumeration of T lymphocyte subsets in peripheral blood with APAAP technique. The results showed that the patients had significantly decreased IL-2 production and lymphocyte response to PHA mitogen. The percentage of Leu 3a (helper/inducer T cell) in the patients was significantly lower than that in normal controls. Leu 3a/Leu 2a (suppressor/cytotoxic T cell) ratio was significantly lower in these patients. The reduction of IL-2 production correlated significantly with the suppression of lymphocyte proliferation but not with the percentage of Leu 3a cells. From these results, it may be suggested that the reduction of IL-2 production in the patients with obstructive jaundice is an important reason for the suppression of T lymphocyte proliferative response, not merely a reflection of the decrease of helper T cells.

Effects of surgical trauma on interleukin 2 production and interleukin 2 receptor expression

To elucidate the mechanism of immunologic abnormalities induced by surgical trauma, we measured interleukin 2 (IL-2) production and IL-2 receptor expression in peripheral blood mononuclear cells from 16 patients with cholelithiasis. Compared with preoperative levels, IL-2 production and IL-2 receptor expression were significantly reduced on postoperative day 4, and the reduction was consistent with the suppression of lymphocyte proliferative response to phytohemagglutinin.

The characteristics and significance of intrathoracic and abdominal pressures during Qigong (Q-G) maneuvering

In order to investigate the mechanism of raising the blood pressure by the Qigong (Q-G) maneuver, the changes of esophageal and gastric pressures were determined during this maneuver, and the data were compared with those from the L-1 maneuver. Eight subjects performed the Q-G maneuver at +1 Gz; their esophageal pressures (mean +/- S.D.) were -6.7 +/- 2.1 mm Hg in the inspiratory phase and 0.1 +/- 3.7 mm Hg in the expiratory phase; intragastric pressures (mean +/- S.D.) were 69.5 +/- 20.2 mm Hg and 63.4 +/- 22.6 mm Hg, respectively. In 22 centrifuge runs at +4.0 to 7.5 Gz and during Q-G maneuvering, 5 subjects had esophageal pressures of -9.0 +/- 3.3 mm Hg in the inspiratory phase and 1.6 +/- 7.2 mm Hg in the expiratory phase, and gastric pressures of 140.6 +/- 23.2 mm Hg and 138.7 +/- 29.5 mm Hg, respectively. The results showed that during Q-G maneuvering, even with a high-G load, the thoracic pressure remained negative or at low pressures while gastric pressures were remarkably raised. They both fluctuated little during respiration; therefore, a relatively large and constant pressure gradient between abdominal and thoracic pressures was maintained. Here lies the significant characteristic of blood pressure raising by the Q-G maneuver. It might possess theoretical significance for further study and development of anti-G maneuvers.

[Chinese strategies for hepatitis B virus markers screening in hepatitis B vaccination based on cost-effectiveness analysis]

By means of decision tree model and cost-effectiveness analysis 15 kinds of programmes which may be used for hepatitis B virus markers screening in vaccination were evaluated. The results showed that the most cost-effective alternative was to identify the negatives for anti-HBc again after testing for anti-HBs and vaccinating all test negatives. That is to say it must not be adopted for persons to be tested for HBsAg, anti-HBs and anti-HBc before being vaccinated. Sensitivity and threshold analysis were also done to determine the effects of changes in the costs of vaccine and screening tests.

The characteristics and theoretical basis of the Qigong maneuver

We have made a systematic experimental study since we proposed the Qigong (Q-G) maneuver in 1986. The purpose of this article is to summarize our 5-year research project. It describes the theoretical problems of the Q-G maneuver, including the mechanism of blood pressure elevation induced by the Q-G maneuver, analysis of the maneuver elements and their respective contribution, the theory and method of muscular contraction in the Q-G maneuver, and the theory and practice of seated posture in the anti-G maneuver. We also describe the characteristics of the Q-G maneuver in five aspects.

Effect of arginine on immune function in rats with obstructive jaundice

In this study we used an experimental model produced by bile duct ligation (BDL) in rats to demonstrate relation between immune function and susceptibility to infection associated with obstructive jaundice and immunoregulatory effect of arginine in BDL rats. Our experimental results showed that thymus weight, content of lymphocytes in thymus and responsiveness to Con A in vitro were dramatically reduced in BDL rats as compared to rats with sham operation and that the impairment of lymphocyte function was significantly related to the susceptibility to infection. Arginine, as a T cell stimulator, markedly improved immune function and decreased susceptibility to infection of BDL rats.

Altered lymphocyte subsets and natural killer cells of patients with obstructive jaundice in perioperative period

Sepsis is a common and occasionally lethal complication of obstructive jaundice. The reasons for the increased susceptibility to infection are not fully understood. This study was conducted to examine lymphocyte subsets and natural killer cells of patients with obstructive jaundice in perioperative period. In these patients, when compared with normal controls, there was a significant reduction in the percentage of Leu 4 (pan T lymphocytes), Leu 3a (T helper cells) and Leu 7 (natural killer cells) before operation, and the immune suppression induced by surgical operation was more marked and persistent.

Alkaline phosphatase, 5'-nucleotidase and magnesium-dependent adenosine triphosphatase activities in the transitional epithelium of the rat urinary bladder

The cerium-based method was used to demonstrate cytochemically the ultrastructural localization of alkaline phosphatase (ALPase), 5'-nucleotidase (5'-Nase) and magnesium-dependent adenosine triphosphatase (Mg-ATPase) on the transitional epithelium of the rat urinary bladder. The reaction product for ALPase was found on the plasma membrane of all epithelial cells, except the luminal surface of superficial cells. The activity of 5'-Nase appeared on the plasma membrane of all bladder transitional epithelial cells, including the free surface of superficial cells. The Mg-ATPase reaction product was seen on the plasma membrane of superficial, intermediate and basal cells, but never on the luminal surface of superficial cells and it was only occasionally seen on the basal surface. The possible functions of these phosphatases have been discussed, and it was emphasized that the 5'-Nase activity present on the luminal surface of superficial cells may play a special role in the membrane movement of these cells in the transitional epithelium.

Ultracytochemical localization of acid phosphatase and trimetaphosphatase activities in the transitional epithelium of the rat urinary bladder

Acid phosphatase and trimetaphosphatase activities have been demonstrated cytochemically in the transitional epithelium of the rat urinary bladder. Acid phosphatase activity was examined by the method of Robinson and Karnovsky (1983), and trimetaphosphatase activity was examined by the method of Kobayashi et al. (1988). Intense positive reaction for acid phosphatase activity was observed with both beta-glycerophosphate and p-nitrophenyl phosphate as substrates, in lysosomes, Golgi complex, GERL, multi-vesicular bodies and wrapping lysosomes. The reaction product of the trimetaphosphatase activity was visualized as fine particulated deposits along the limiting membrane of some lysosomes, and of tubular structures located in the basal cytoplasm. There seems to be a fine distinction and reciprocal complementary functional relationship between two kinds of lysosomes containing either acid phosphatase or trimetaphosphatase activity.

Hepatic coccidiosis in the goat

Coccidial oocysts were seen in the bile from five goats infected with coccidia either naturally or artificially. The oocysts measured on average 21.3 by 18.3 microns and resembled those of Eimeria ninakohlyakimovae. Livers and gall bladders of infected animals showed various degrees of histopathological changes. In the worst case, bile had a thick consistency and contained blood and necrotic debris. Apart from those in the bile, oocysts were seen in liver smears and in the centrilobular vein in two histological sections. Forms resembling meronts and measuring on average 200 by 147 microns were seen in sections of bile duct.

Basic vascular anatomy and the reimplantation of the amputated hand through the palm

Thirty adult upper extremities were used to study the blood vessels of the hand by angiography, cross-sectional measurement and operative microscopic dissection. The arteries in the middle segment of the palm are arranged in three planes, while in the upper or lower segment there are two planes only. The division of the territories of the radial and ulnar arteries are not same in the three different layers. There are three main anastomotic pathways between the radial and ulnar arteries in the radial-ulnar direction, while in the palmar-dorsal direction there are three anastomotic zones between the palmar and dorsal planes. According to the rate of appearance, sources, cross-sectional area, irrigation territories and anastomoses of the arteries in the three segments, the clinical significance in the reimplantation of the amputated hand through the palm has been discussed.

[Comparison of renal carcinoma in two periods: analysis of 129 cases]

From 1954 to 1988, 129 patients of renal carcinoma were admitted to our hospital. The 129 cases were divided into two groups for comparison and analysis. Since 1980, examinations of model B ultrasound, CT scanning and arteriography have been popularly used in the diagnosis, many cases of renal cell carcinoma can be early found and treated, so the prognosis has been markedly improved. In this group, the total 5-year survival rate was risen from 27.7% to the 58.8%.

[Differential diagnosis of tuberculotic lung tumor and peripheral lung cancer]

This report discusses the two diseases differentiated characteristics in age, diseases time, clinical signs and symptoms, location and size of lesions, exercise with radiographs and fiber bronchoscopy and cytologic etc. by experience of diagnosis and treatment to 94 patients of lung tuberculosis tumor and 196 patient of peripheral lung cancer for ten years. This article summarizes that early diagnosis characteristic of lung cancer is: asymptomatic in clinic, most patients are over 40 age, less lesions as satellite on a sectional roentgenography. The lesions still gradually develop, through treatment effectively tuberculosis, and the article suggests that the lung tuberculosis tumors that they may be cancer but diagnosis is doubtful in clinic should be treatment by operation.

[Forecasting strategies of hepatitis B vaccination based on decision tree model]

The strategies of hepatitis B vaccination was studied based on the decision tree model. The results showed that the young, especially newborn should be given the highest priority for vaccination and the best strategy to the neonate is vaccination without screening for HBsAg to their mothers. The results also showed that the population groups who can take positive benefits (BCR greater than 1) after being vaccinated can be enlarged if decreasing the costs of the vaccination and tests for hepatitis B virus markers, and increasing the protect rates and years of vaccination. It told us that we should not only pay attention to the study for the more effective and cheaper vaccine, but manage scientifically and use reasonably as well.

A preliminary report on a new anti-G maneuver

Inspired by Traditional Chinese Medicine and Qigong, we designed a new anti-G maneuver, the Q-G Maneuver, which has proved promising. This maneuver consists of volition mobilization, stepwise tensing of leg and abdominal muscles, and maintenance of a shallow thoracic respiration throughout. It was tested on 24 pilots on the ground and 3 pilots on a centrifuge. All pilots were monitored with heart level blood pressure, oximetry, ear lobe pulse, CO2 concentration in exhaled gas, EEG and ECG; in centrifuge runs, peripheral vision was also monitored. Blood pressure was maintained at 180-240 mm Hg for more than 30 s without fatigue. On the centrifuge, the pilots tolerated a G load 2.25-3.0 G higher than without the maneuver, without any visual disturbance. Oximetry readings were 96-97%, and there was no evidence of hyperventilation. The ear lobe pulse was even enhanced during G load with the maneuver. Follow-up visits to 18 out of 24 pilots with 455 inflight applications of the maneuver showed that the maneuver is feasible and can be used effectively during high-G load.

[Melanoma of ganglion cells arising from a thoracic sympathetic ganglion in an adult--a case report]

One case of pigmented tumor arising from the thoracic sympathetic ganglion in a 33 years old man is reported. By microscopy, the tumor cells were arranged in nests, among which ganglionic cells were observed. By Masson-Fontana and Lillie's stain, the pigment in the tumor cells was positive for melanin. By Glees-Marsland's stain, neurofibrils were demonstrated in the cytoplasm of some tumor cells. The presence of melanin and neurofibrils in the tumor cells and the interstitium proves that the tumor is a real melanocytic one arising from the sympathetic ganglion and that both the ganglionic and melanocytic cells originate from the neural crest. The malignancy of this tumor was also evidenced by the rapid extensive metastases occurring half a month after the operation.