1980年 · 第93卷第07期

This paper presents a clinicoelectroencephalographic analysis of 41 cases of infantile spasm. The essential up to date literature is reviewed. Inasmuch as serious mental retardation may result owing to lack of timely and adequate treatment, it is important to start ACTH therapy, though not entirely satisfactory, at the earliest possible moment. Of 14 cases treated with ACTH alone or combined-with nitrazepam complete recovery was registered in one and remarkable improvement in two, while the remaining cases somewhat improved. The cases have been followed up from 1 month to 5 years.

The blood volumes of skin, muscle, ulna and radius of both rabbit forearms were investigated with 51Cr-labelled red blood cells after a standardized contusion of the soft tissues of the left forearm was produced. Blood volume increased in nearly all the forelimbs after contusion due to generalized vasodilation, many increases being statistically significant. The blood volumes of skin and muscle soft tissue similarly had a tendency to increase with 2 peaks of increased blood volume. Bone blood volume of ulna and radius also had a similar pattern of 2 peaks of increased blood volume. The blood volume patterns showed soft tissue peak blood volumes when bone blood volumes reached their lowest values. Radix Salviae Miltiorrhizae action was masked by the generalized vasodilation after soft tissue contusion.

During 1948-1976, 363 cases of ovarian serous tumor were encountered in the hospital. Among them, 58 cases were pathologically compatible with the criteria of this tumor of borderline malignancy proposed by the WHO classification. The purpose of this paper is threefold: 1. To study the clinical behavior and mode of development of pathologically documented borderline malignant serous ovarian tumors. 2. To compare the difference between benign, borderline malignant and malignant serous tumors. 3. To assess the value of making such a "borderline malignant" subgroup.

Chiasmal region tumor caused apoplexy is not uncommon. As its clinical picture varies and is complicated, early diagnosis is usually difficult. 7 cases are reported with marked visual loss, the presenting symptom. Visual fields all revealed definite chiasmal lesions and were indications for neurosurgery. Postoperative results were all encouraging. The important symptoms and signs of this apoplexy are: abrupt severe headache, nausea, vomiting and even meningeal irritation, loss of visual function, ocular palsy and symptoms caused by the tumor itself. These symptoms may be mild or severe and may improve and then relapse and may appear simultaneously or one after the other. Onset is usually abrupt and may subside gradually or end in death. Visual field examination is very important to making a correct diagnosis. In many reports the diagnosis is made only at operation or autopsy.

63.6% of 1,013 dead fetuses and newsborns are autopsied and analysed for the causes of death in order to improve the result of treatment. Anoxemia is the main cause of death in fetuses, followed by malformation. While in newborns the main causes of death are pulmonary diseases, followed by intracranial hemorrhage (traumatic and anoxemic), malformation and anoxemia. Measures for guarding against premature births and perinatal mortality are the improvement of perinatal and maternity cares.

In 1972 gossypol was shown to have a potent antifertility effect in man. Further clinical trials indicated that in certain districts such as Nanjing occasional cases of hypokalemia or even hypokalemic paralysis may occur during gossypol administration. There were contradictory views concerning the etiology and pathogenesis of this hypokalemia. The authors carried out a series of clinicopharmacologic observations on gossypol related hypokalemic patients. The occurrence of hypokalemic paralysis is far more frequent in gossypol takers than in the control population, suggesting that gossypol may be a causative agent of the disorder. In addition, other factors such as low dietary potassium may also contribute to the development of the hypokalemia. In these patients, total body potassium is low and 1 of the apparent causes of body potassium depletion is renal potassium loss which appears not to be due to hyperaldosteronism. The use of potassium salt at the stage of fatigability, a sure prodromal symptom of impending hypokalemic paralysis, is effective in the prevention of paralysis but for final resolution of the problem, the authors believe that increase in the dietary potassium level or even modification of the gossypol molecule may be necessary. Observation of the urine/serum potassium ratio in high water diuresis may be helpful to the diagnosis of normokalemic potassium deficiency.

For 2 years the immunohemagglutination inhibition test, using glutaraldehyde-treated human "O" red blood cells as the carrier of antigen (fibrinogen), has been done to determine the fibrin and/or fibrinogen degradation products (FDP) in the blood and urine of patients with renal diseases. FDP was present in appreciable amounts in the urine of 68% of 136 patients with nephritis, while among 24 patients with nephrosis, only 17% showed weakly positive results (<1.25 μg/ml). The results of the determination of blood FDP were inconsistent. Thus, only urine FDP determination seems to be of value in diagnosing nephritis and in differentiating it from nephrosis. The fact that the amount of urine FDP did not correlate with the amount of blood FDP or the degree of proteinuria indicates that the urine FDP in nephritis is not a result of leakage from the blood to the urine, but probably forms locally in the kidneys. Thus, coagulation and fibrinolysis seem to play a role in the pathogenesis of nephritis but not in nephrosis. Urine FDP determination is also of value in diagnosing rejection of transplanted kidneys.

Two cases of transorbitocranial foreign body injury, one by glass splinters and the other by a chopstick were reported. Shugrue's operation for removal of the foreign body was performed for the former case. The patient is living and well. The other case was only treated medically. He finally died of suppurative meningitis. In the management of penetrating orbital wounds, the authors emphasize the possibility of cranial cavity involvement with brain injury.

The authors report their experience in resecting hepatocellular carcinoma (HCC) in the early stage. Of their 22 cases with small HCC, 16 were found at mass screening (alpha fetoprotein detection) and 6 were hospital patients. There were no operative deaths. 5 patients died following recurrence. 1 patient has survived over 9 years. The 3-year survival rate is 70.5%.

At a panel discussion, medical workers from some 20 hospitals in Beijing exchanged experiences and views on the clinical aspects of sick sinus syndrome. In a combined series of 171 cases, coronary heart disease (91 cases) and cardiomyopathy or myocarditis (37 cases) were found to be the most common causes. 38 cases were of unknown etiology. The main clinical and ECG features were reviewed. Problems in diagnosis were discussed with particular emphasis on the use of accessory diagnostic methods, such as atropine test, exercise test and ECG monitoring. Experiences in treatment with combined traditional Chinese and western medicine as well as with the use of artificial cardiac pacemakers were exchanged.