1981年 · 第94卷第02期

Adolescents' developmental status involving menstruation, nocturnal emission, secondary sexual characteristics as well as general physical and functional measurements is studied in 3,267 students and the demarcation of the age and stages of adolescence is attempted in order to provide a basis for programming health service for adolescents and for further follow-up investigation.

Three cases of differing types of double parasystole are reported: atrial parasystole complicated by A-V junctional parasystole, atrial parasystole complicated by ventricular parasystole and double ventricular parasystole arising from 2 different foci. The 3 patients all suffered from organic heart disease. Our first case of atrial and junctional parasystole was complicated by Woff-Parkinson-White (WPW) syndrome. The sinus, atrial and junctional impulses activated the ventricles through their respective specific conduction pathways, resulting in 3 different QRS patterns.

18 cases of endocardial cushion type atrial septal defect are classified in this paper into 4 categories according to their pathologic changes: ostium primum type, portional common atrioventricular canal, complete common atrioventricular canal and single atrium (common atrium). Analysis is also made of the clinical symptoms, signs and features manifested in ECG, X-ray, cardiac catheterization and angiocardiography. A brief account is given of the diagnostic characteristics of each type of endocardial cushion defect as well as the basis for differential diagnosis from ostium secundum type atrial defects, Lutembacher syndrome (ostium secundum type atrial defects with mitral valve lesions), theumatic mitral disease and total anomalous pulmonary venous drainage. Finally, the mode of operation on endocardial cushion defects and the treatment of mitral insufficiency caused by mitral leaflet clefts are discussed.

24 cases of burns in pregnant women are described. The relationship between the burn area, gestational age and treatment and prognosis is analyzed. Active treatment is advocated.

In Chengdu area most cases of septicemia of biliary origin are due to suppurative cholangitis, primary cholangiolithiasis and biliary ascariasis. Two autopsies in this series showed thrombi mixed with free billirubin particles in numerous hepatic veins and pulmonary blood vessels. These specific findings indicate the actual passage by which bacteria bile enter the systemic in the contaminated circulation and cause septicemia as a result of acute biliary obstruction and infection. This paper analyses the clinical features and operative findings in 62 cases and the autopsy data in part of them. The causes, mechanism, diagnosis and treatment of the disease are discussed.

The clinical data and evaluation of 408 selected patients with esophageal carcinoma treated by combined preoperative irradiation and surgery are reported. The majority of these patients had tumors of poor or questionable resectability as evaluated on clinical grounds before treatment. The primary tumors were located in the upper and middle thirds of the esophagus in 79.9% and were yp-TNM Stages III and IV in 81.6%. In only 18.4% was the tumor found to have no extra-esophageal invasion or lymph node metastasis. In this group the resectability rate was 81.9%, operative mortality 3.4% and the 5- and 10-year survival rates were 31.6% and 21.9%. During the same time period 736 patients with tumors more distally located and of better resectability were treated by surgery alone. In 43.8% of these the tumor was located in the lower third of the esophagus. The operative mortality was 3.0% and the 5-year survival rate 27.6% in this group. Comparison of the results of the 2 groups led to the conclusion that adjuvant preoperative irradiation used in the present series enhanced surgical results. Rationales and guidelines for application of combined therapy are also discussed.

Audiofrequency electrotherapy (AFET) is used in 140 intestinal adhesion (IA) cases regardless of patient's age, duration of illness, severity of symptoms, number of operations and recurrences and failure of other methods of treatment with 72.8% cures, 18.6% marked improvement (over 50% improvement) and only 8.6% failures. Follow up observations on 40 cases showed that 29 remained well, 7 had occasional mild attacks of abdominal discomfort and/or pain which did not interfere with work and only 4 had recurrences. The treatment relieved signs, symptoms and complications including pelvic inflammation, peritonitis, intestinal obstruction9 abdominal masses, lumbar pain, diarrhea, nocturia, general anasarca and obstipation and is the treatment of choice in this hospital.

44 cases of coronary heart disease are treated by acupuncture. 29 are markedly improved, 13 improved and 2 unchanged. Selection of points are described and the mechanism of treatment discussed in relation to various factors, from the angle of traditional Chinese medical theory.

We have successfully treated 2 series of patients with the "incurable disease" scleroderma with Chinese traditional medicine according to the traditional medicine principle of stimulating circulation to end stasis (SCES) 活血化瘀 (Huoxue huayu) and have found it useful. Its value was first seen in the first series of 104 cases treated from May 1960 to March 1966 and later confirmed in the second series of 123 cases. In the second series, in addition to the decoction we added intralesional and/or acupuncture point injections of herbal extracts. Of the 123, 43 were systemic scleroderma and 80 circumscribed scleroderma. In the systemic group, the effective rate was 97.7%, of which 37.2% had marked improvement, while in the 80 cases of circumscribed scleroderma the figures were 97.5% and 46.3%. The histopathologic changes under light and electron microscopy confirmed the therapeutic efficacy of the combined treatment The main SCES therapeutic effect appears to be improvement of circulation, especially the microcirculation, and connective tissue metabolism.

This article deals with further studies on the etiology of a larger series of autumn infant gastroenteritis (AIG) in Beijing in 1979. Fecal samples were collected from 126 and 52 cases in 2 hospitals. The positive rate of rotavirus detected by simple direct electron microscopy (EM) was 38.1% in 1 hospital and 19.2% in the other. Ultrasections were made from fecal sediment of the cases with negative findings by simple direct EM. The positive rate of rotavirus detected by ultrasection EM was 75.6% in 1 hospital and 52% in the other. The total detection rate obtained by the combined use of these 2 methods reached 84.9% in 1 hospital. In 1 hospital, adenovirus was found simultaneously with rotavirus in 3 and singly in 2. In the other hospital, adenovirus was found simultaneously with rotavirus in 1. Paired sera were obtained from 49 cases, of which 37 (75.5%) showed a 4-fold or higher rise in complement-fixing (CF) antibody to rotavirus, mostly a 32-fold or higher rise. Single convalescent phase sera were obtained in 6 cases which all gave high rotavirus CF antibody titers. Fecal samples were inoculated into primary thesus monkey kidney monolayer cell cultures for virus isolation. Apart from isolation of a Type 19 ECHO virus strain from 1 case, addition of trypsin to the fecal samples, maintenance media or both showed no cytopathic changes. A crude extract of a rotavirus particle-positive fecal sample was fed to 4 newborn piglets and one 3-month-old thesus monkey, none of which developed diarrhea. Fecal samples of 133 of the 178 cases were cultured for bacteria. Only 8 cases (6%) showed pathogenic Escherichia coli growth.