1981年 · 第94卷第08期

Long term results of surgical treatment of 271 cases of thyrotoxicosis treated in the People's Hospital of Beijing Medical College from 1960 through 1976 are evaluated. There were 206 females and 65 males with ages ranging from 15 to 66 years. 218 (80.4%) were primary hyperthyroidism and 53 (19.6%) toxic nodular goiter. There was no operative mortality. Post-operative respiratory distress requiring tracheostomy occurred in 8, all recovered without sequelae after decanalization. Thyroid crisis was encountered in 3 and all were cured. 247 (91.9%) were followed up to December 1979, an average 9 year follow up period. Of 247, permanent vocal paralysis developed in 3 (1.1%) and permanent tetany in 3 (1.1%) others. During follow up the recurrence rate of hyperthyroidism was 2.1% and the incidence of hypothyroidism 0.8%, giving a cure rate of 97.1%. In correlating the final results of surgical treatment with the amount of thyroid gland preserved after resection, it was found that a preservation of 3-5 gm in all of the thyroid tissue, or 3-6% of its original weight, gave the best results. From this analysis, it is concluded that surgical treatment is the method of choice for thyrotoxicosis.

2 cases of infantile and juvenile amaurotic familial idiocy, 1 clearly of nationality origin are presented.

A review of the study and control of para-gonimiasis is made, the treatment of choice is bithionol. 15 new species and subspecies of paragonimus and the intermediate and reservoir hosts are discussed.

This paper reports the application of peripheral motor nerve conduction velocity (MNCV) determination and 6 noninvasive autonomic functional tests for the early diagnosis of diabetic neuropathy. Among the 150 cases of newly discovered diabetics investigated during extensive survey in Shanghai, 135 cases of diabetic neuropathy were diagnosed. In this group, patients with both neurologic symptoms and signs were found in 56 cases, only symptoms with no signs in 50, only signs with no symptoms in 8 and both symptoms and signs absent but diagnosis based on special tests in 21. The motor nerve conduction velocity of the median n., ulnar n., and fibular n. were ascertained on JD Type II electromyography. The velocity was found to be significantly slower in diabetics with neuropathy than the control group. H-reflex and tibial n. latency were found to be prolonged in diabetics as compared with the control group. There is negative correlation between the MNCV and fasting plasma glucose and positive correlation between the H-reflex and fasting plasma glucose, indicating that hyperglycemia may be closely related to the pathogenesis of diabetic neuropathy. No correlation was found between the MNCV, age and duration of diabetes. For early diagnosis of diabetic neuropathy, besides the symptoms and signs, motor nerve conduction velocity and 4 of the 6 noninvasive autonomic nerve function test are valuable and reliable diagnostic procedures. Differential diagnosis from other causes of neuropathy is also emphasized.

Treatment of diabetic neuropathy is a difficult clinical problem. In this paper, clinical experience on managing 120 newly discovered, untreated, noninsulin dependent cases is presented. Besides strict control of diabetes, the therapeutic effect of different drugs including the vitamin B group, myoinositol, carbamazepine, etc for neurologic manifestations is investigated. No statistical difference was found between groups with or without drug therapy. So the strict control of diabetes with attenuation of hyperglycemia has been considered the sole reliable factor for the effective therapy of neuropathy. Motor nerve conduction velocity was restored to a certain extent in different peripheral nerves indicating that early functional nerve damage is reversible on diabetic therapy. Neurogenic bladder and other autonomic dysfunction can also be remitted. While both peripheral and autonomic neuropathy can be improved on diabetic control, early diagnosis and treatment are the key to obtaining good therapeutic effect.

During the past 9 years, much research has been carried out in our country on chronic bronchitis. Massive antibronchitis campaigns have seen Chinese traditional medicines investigated, synthesized and popularized, vaccines are used when necessary and the majority of cases improved symptomatically. The contradiction between clinical improvement and deterioration of objective parameters is to be studied.

Human C-peptide in 10 normal subjects and 33 diabetics divided into insulin dependent, insulin independent and late insulin dependent groups is studied, showing that blood C-peptide level indirectly but accurately reflects beta-cell insulin secretion capacity.

The effectiveness of aprindine in reducing ventricular extrasystoles is investigated in 17 patients suffering from acute myocardial infarction and 1 with ventricular tachycardia episode but no evidence of acute infarction. It is found that aprindine is not only effective against ventricular extrasystoles when given orally to patients with ischemic heart disease but also is a drug of choice for premature ventricular contractions. However, the side effects of the drug, particularly agranulocytosis, will probably keep the drug from being the one of choice in chronic premature ventricular contractions.

This paper presents a comprehensive report on a clinical trial of injectio Fructus Aurantii Immaturus (FAI) in 100 cases of pediatric septic shock at 9 hospitals in Hunan province with 78% efficacy. The herb has significant, fast action on blood pressure elevation with few side effects. The mechanism of the drug's action, method of clinical use, toxicity and side effects are discussed in detail.

The diagnosis and treatment of 10 cases of chronic cor pulmonale caused by schistosoma japonicum is discussed. There is no effective treatment once the pathology is well established, so early diagnosis and treatment are mandatory.