1981年 · 第94卷第10期

120 primary amenorrhea cases are clinically analyzed and 10 different causes are evaluated. 69.2% are due to congenital causes, congenital ovarian dysgenesis is the most frequent, while pure gonadal dysgenesis the second. Diagnosis for each kind is introduced. Clinical manifestations such as height, secondary sex characteristics, virilism and hirsutism and external and internal genitalia are hints for differentiation of various diagnosis. Management for each kind is discussed.

Toxemia of late pregnancy greatly influences fetal survival. The fetal mortality rate is 10.71% being 1-5 times above normal. The main causes of fetal death are prematurity, intrauterine anoxia, asphyxia, premature placental separation, hyperplacentalism, etc. Besides the onset and duration of the attack, severity of toxemia has a close relationship with fetal death. The prevention and management are: intensive treatment, use of the placental function test to judge the in utero fetal condition and stressing 5 indications for termination of pregnancy.

Fosfomycin is a broad-spectrum bactericidal agent acting on the early stage of synthesis of the bacterial cell wall. Its chemical structure differs entirely from those of the known antimicrobial agents and bacteria show no cross resistance towards fosfomycin and other antibiotics. The outstanding features of fosfomycin are low toxicity, high blood concentration after intravenous administration, moderate absorption when given orally, low serum protein binding, can be chemically synthesized and good diffusion into tissue and body fluids. Fosfomycin orally or intravenously had been employed in 184 becterial infections in this country with an effective rate of>80TO, another 203 locally treated cases with various infections also responded favorably. Side effects were rather mild consisting mainly of gastro-intestinal reacitons and occasionally skin rashes and elevation of serum glutamic-pyruvic transaminase. There was no adverse influence on renal function.

Addition of fluorescein isothiocyanate-labeled or 125I-labeled immune ascitic fluid IgG antibody against Type 4 dengue virus onto brain imprints of newborn mice and coverglass cultures of Aedes albopictus mosquito cell line infected with the prototype strain of Type 4 dengue virus showed specific fluorescence in the cytoplasm which could be inhibited by unlabeled specific antibody or gave a positive result by radioimmunoassay in all of them. Results in all the corresponding uninfected imprints and coverglass cultures were negative. When labeled antibodies were added onto those infected with Type 2 dengue virus or Japanese B encephalitis virus, no positive results were obtained by immunofluorescence or radioimmunoassay. Results by these two methods in a proportion of the head squashes of laboratory-bred female Aedes albopictus mosquitoes which had sucked the blood of mice infected with Type 4 dengue virus were positive, whereas in those mosquitoes which had not sucked the blood of infected mice the results were all negative. Type 4 dengue virus antigen was positive by both methods in a proportion of head squashes and of salivary gland, stomach and ovary squashes of female Aedes albopictus mosquitoes captured from the epidemic region of dengue fever. On the other hand, in those feruale Aedes albopictus mosquitoes bred in the laboratory in nonepidemic region, the results were all negative.

Fecal samples from 9 cases of autumn infantile gastroenteritis and paired sera from 4 of them were collected in 1980 during an epidemic of the disease. By means of direct electron-microscopic observation, rotavirus was found in 3 out of the 9 cases and astrovirus and rotavirus in 1. The morphologic characteristics of astro-virus were typical. Immune electronmicroscopic examination, using the concentrated and purified virus antigen and the convalescent phase serum from the latter case, showed aggregations of large numbers of astrovirus particles connected to each other by thin antibody-bridges, giving a characteristic picture of immune complex. This indicates that astrovirus may be one of the etiologic agents of this disease.

Exfoliated cells collected by negative pressure suction from the nasopharynx of patients with poorly differentiated and undifferentiated cell carcinoma and of suspect nasopharyngeal carcinoma (NPC) patients were examined for Epstein-Barr nuclear antigen (EBNA) by anti-complement immunoenzymatic method (ACIE). All 79 NPC patients had EBNA-positive carcinoma cells, while the positive rate of cytologic and histologic examination was only 87.3% and 91.1%. No EBNA was found in tumor cells from patients with head and neck malignant and benign tumors other than NPC, nor was it found in nasopharyngeal epithelial cells of dead fetuses. 6 persons with EBNA-positive cells detected by this method, with no carcinoma detected by cytology or histology, were reexamined regularly. Carcinoma cells were detected from 1 week to 3 months later in 4. This shows that this ACIE method is specific and sensitive and can be used for early NPC detection, especially in combination with serologic detection of Epstein-Barr virus (EBV) antibody. Besides finding EBNA in nasopharyngeal carcinoma cells, it can also be found in normal ciliated columnar epithelial cells and hyperplastic cells of the nasopharynx.

In chronic aplastic anemia Androst-4-ene-3β, 17β-diol dicyclopentylpropionate (ADCP) is comparable to testosterone propionate (TP) in efficacy and is milder in side effects. Moreover, since ADCP does not require daily injections as TP, longterm treatment is acceptable to most patients. Research attempts to further lengthen the intervals of ADCP injections will, therefore, be worthwhile. Also of importance will be the study of the value of various 3β, 17β-diesters of androstenediol in the treatment of chronic aplastic anemia.

80 typical cases of Wilson's disease were observed over 54 years, 58 of whom were hospitalized, an incidence of 19.7 per 100,000 general hospital inpatients and 522 per 100,000 neurologic inpatients. The average age of onset was 23.5 years. Average age of onset before 15 years was 50%, between 20-30 26.91% and before 30 76.59%. 51.25% of our 80 patients had first involvement of the nervous system commencing at an average age of 25.2 years and 95% exhihited neurologic symptoms and signs. 39.99% had primary onset of hepatic disorder at an average age of 14.2 years and 80% showed evidence of hepatic dysfunction. 3.99% had renal involvement as first manifestation of disease and 40% showed evidence of renal damage. Aminoaciduria was demonstrated in 6.25%, 0.5% had affection of bones and joints, 2.5% had mental symptoms as first manifestation of the disease and 46.25% showed mental symptoms. 3 showed evidence of heart involvement. EEG findings and study of copper content of brain and liver will be presented in other papers. Autopsy was performed on 5 with typical findings of Wilson's disease. Copper oxidase activity was lowered in 95%. Kayser-Fleischer ring was found in 73.75%. Urinary copper content was high in 96.97% (32/33 cases). Serum copper content was low in 65.22% (15/23 cases). 62 of our 80 patients (77.50%) had well documented family histories. It was positive in 10 patients of 9 families and highly suspected in another 4 in agreement with autosomal recessive heredity. With regard to prognosis 11 patients remain apparently healthy, 38 continue working or studying while taking treatment, 24 are invalids and 7 died. It appears that the longer the interval between onset, of disease and diagnosis, the worse the prognosis, indicating the importance of early diagnosis and treatment.

The results of a follow up study on the ultimate outcome of 4 cerebral hemispherectomized cases which were operated upon more than 20 years ago for infantile hemiplegia are reported. One case is still fairly healthy more than 22 years after hemispherectomy. The neurologic function of this case is examined, including a CT scan of the skull. The other 3 cases died 20, 7 and 6 years after the operation, each showing a period of improvement for a few years and then deteriorating neurologically. The probable cause of death is delayed persistant intracranial hemorrhage with or without hydrocephalus. The results of the operation may be improved if cases are followed up closely to prevent this delayed complication.

The situation of tuberculosis and its effective control in Beijing in the past 30 years, 1949-1979, are briefly reviewed. During this period, the mortality from this disease dropped from 230.0/100,000 to 10.0/100,000, average death age rose from 28.5 to 66.8 years, and the percentage of deaths among deaths of all causes from 16.3 to 1.8%. Measures for combating the disease are described.