1982年 · 第95卷第08期

As 200 million of China's 300 million children (under 14 years of age) live in the countryside where specific child health care had been nil, with setting up of a child health care network in 19 provinces and cities perinatal health work has improved, neonatal deaths cut and infant nutrition and child health care improved.

Cisplatin 顺铂 has been prepared, studied, and utilized in many parts of China as an anti-cancer agent since 1974. This article briefly presents our experiences with the drug. A summary of clinical trials in 217 advanced cases of 35 kinds of neoplasms is presented. The results are analyzed. Cisplatin has been successfully used in disseminated lymphosarcomas by supplementary intralymphnode injection. Use of dimethyl sulfoxide (DMSO) to solubilize the drug apparently facilitates cell membrane penetration. Combination of cisplatin treatment with radiotherapy has proved to be synergistic. The possible mechanism of cisplatin action and invention of an instrument fOr intraendoscopic administration of the drug are discussed.

Silk vascular prostheses have been used clinically since August 1957 with no clinical ruptures. The longest follow up is 18 years in extremity artery aneurysmectomy, 13 years and 8 months in thoraco-abdominal aortic bypass and 14 years in abdominal aorta aneurysmectomy with patency rates of 70-80%, 92% and 96.2% in 498 cases operated upon. Silk prostheses are physicochemically inert, do not cause host foreign body expulsion reaction, nonallergenic, noncarcinogenic, durable, sterilizable, inexpensive, easily manufactured, porous, seamless, elastic (do not collapse or kink on bending), thermostable, not modified by weak acids or alkalis and have no noticeable tensile strength change after contact with pH 7.4 human blood. For successful grafting meticulous surgical technic, strict asepsis, proper graft caliber and strength, good run-off, good host vessel condition and 3-4 week postoperative bed rest are mandatory. Silk prostheses suffer partial loss of elasticity and corrugation on autoclaving, at less than 5 mm diameter prostheses patency is only 40% and vein graft value is questionable, these require improving.

The chronobiologic medical theories in Neijing are a treasure of traditional Chinese medicine, the main principles are: People and nature are an entity. Human physiologic and pathologic activities correlate with the periodic changes of nature, so have infrannual, circan- nual, circamonthly and circadian rhythms. If human rhythms are disturbed by abnor- malities of human activity or nature, or people are attacked by pathologic factors during the susceptible phase of their normal rhythms, they easily fall ill. Pathologic changes in human rhythms (ab- normalities in or loss of rhythm) are valuable parameters of diagnosis in determining disease location, nature and transformation. Prevention and treatment should be suited to the time. The doctor must understand the laws of the rhythms of nature and humans.

In a series of 735 diabetics, a search for ocular signs other than diabetic retinopathy to help diabetes diagnosis suggests that reduced corneal sensitivity, somewhat high intraocular pressure and heightened dark adaptation threshold without significant cause all may indicate diabetes mellitus.

Clinical results of extra-intracranial arterial bypass (EIAB) for cerebral ischemic stroke are assessed in 278 patients. 223 had marked improvement and 19 fully recovered without any neurologic residue. The percentage of improvement is 87% (242/278) and mortality 1.7%. Angiography demonstrates graft patency in 61 of 80 patients. 3 year study of 41 patients suggests that EIAB protects against further clinical cerebrovascular diseases. The authors believe that in patients even with moderate or severe complete stroke, EIAB should be tried. About 76% had been ill more than 6 months before surgery.

40 adults with fourth ventricle tumor admitted from January 1972 to January 1978 are reported. Among them 29 were totally resected, 11 subtotally resected and 16 received postoperative irradiation. Three totally resected cases died shortly after operation of acute brain stem edema, an operative mortality of 7.5%. The remaining 37 survived and were followed up for 2 to 8 years. 10 cases died of tumor relapse. Of the 29 totally resected cases, 21 are still alive. The author discusses prognostic factors and clinical experience in treating fourth ventricle tumors. Ventriculogram characteristics are also described.

168 members of 29 families with hemophilia A were studied for detecting and discriminating the carriers. Factor Ⅷ related coagulant activity (Ⅷ:c), related antigen (Ⅷ:Ag) and ristocetin cofactor (ⅧR:RCoF), and factor Ⅸ coagulant activity (Ⅸ:C) were used as laboratory parameters, and different methods for discrimination were described. The results showed that Ⅷ:C/Ⅷ:Ag ratio was the best discriminator regardless of methods of discriminant analysis and efficacy of discrimination was better in carriers of severe hemophilia than in carriers of mild case.

A case of incontinentia pigmenti with incipient cataract is reported. A review of the literature indicates that about 1/3 of the cases have ocular manifestations. The pathogenesis, clinical features and ocular signs are described briefly.

Cyclic adenosine monophosphate (cAMP) content of CSF in 94 cases of nervous system inflammatory diseases is measured. Statistically significant increases are found in tuberculous meningitis, encephalitis, cerebral arachnoiditis and cysticercosis cerebralis showing the most prominent increase, varying in accordance with the severity and progress of the disease. The mechanism of increase in CSF cAMP is briefly discussed in relation to the literature and the possible clinical application of CSF vAMP content measurement.