1984年 · 第97卷第09期

We conducted a field survey on 53 workers in a battery factory, 52 solder workers, and 50 embroidery workers (control group). The average air lead levels at the workplaces of these three groups were 0.578 mg/m3, 0.0015 mg/m3 and 0.006 mg/m3 respectively. Clinical and biochemical studies revealed that the workers in Shanghai Navigation Battery Factory were affected somewhat by the toxic effects of lead. The solder workers showed no significant abnormalities compared with the control group. A significant dose-response relationship existed between air lead levels and toxic effects. The early clinical manifestations observed were dysfunction of the central nervous system, dyspepsia, joint pain, and myalgia in the extremities. A positive association was observed between the prevalences of fatigue, mild abdominal pain, and joint pain and the blood lead (PbB), urine lead (PbU), and zinc protoporphyrin (ZPP) levels. The symptomatic threshold values for PbB, PbU, and ZPP were 30 μg/dl, 0.045 mg/L, and 40 μg/dl, respectively. Although the PbB, PbU, δ-aminolevulinic acid dehydratase (ALAD), free erythrocyte protoporphyrin (FEP), and ZPP levels could be used as criteria of lead exposure, the measurement of ZPP is the first-choice screening test for a preventive monitoring program. The motor and sensory conduction velocities in the median nerve were slower in the exposure group than the control group (p<0.05). Conduction velocity and intensity of lead exposure were not significantly correlated. No apparent effects on behavioral function were observed among the solder workers.

This paper presents 181 cases of severe post-poliomyelitic deformity of hip joint surgically treated from June 1969 to December 1982. 67 were male and 114 female with age ranging from 11 to 28 years, averaging 19 years. The surgical methods usually used in our series are oblique and rotational osteotomy of the femoral trochanteric region, limb-lengthening through femoral tuberosity and intracapsular shelf operation which can correct various hip deformities, stabilize the hip joint and improve weight-bearing function at the same time. 149 (82.3%) cases were followed up from 9 months t0 13 years, averaging 4 years and 2 months. Results were satisfactory in 140 (94%), excellent in 90 (60.4%), good in 50 (33.6%) and unimproved in 9 (6%). The clinical types of deformities, surgical indications and the relationship between surgical procedures and weight-bearing function are discussed.

In order to ensure regularity of ambulatory treatment of new cases of pulmonary tuberculosis, a fully supervised intermittent chemotherapy regimen was tried in 2 rural counties of Beijing. The "bare foot doctors" of the village health cooperatives were designated to administer and supervise every treatment. The regimen was chosen taking into consideration of the effectiveness, side-effects, acceptability, cost and supply of drugs, and consisted of INH and SM daily for one month, then every three days for five months, and then every five days for 6 or 12 months. For smear-negative cases, the daily phase was omitted. The percentage of compliance among 229 cases in 1 year was 94.2%, including those who missed one or two treatments only. The sputum conversion rate among 103 sensitive cases was 98.1% and that of resistant cases was 63%. Changes of regimen due to side-effects was 1.3%. The bacteriologic relapse rates during one-year follow-up were 2.1% among the initial sensitive cases and 4% among the initial resistant cases. A reserved regimen consisting of rifampin (RFP) and ethambuto (EMB) was applied to the sputum non-converted cases in the programme of field work. This made an overall sputum conversion rate up to 98%. The average overall cost of drugs for each case was about 49 yuan (RMB) (roughly 25 US dollars).

Health conditions in the Huainan Coal Mine have improved greatly since 1950. In particular, the working and living environments, the underground dust concentration, the water supply and waste disposal systems, and the nutritional value of miners' food have become much better. Thus the rates of occupational,infectious, and parasitic diseases and nutritional deficiency diseases among miners have decreased considerably. The falls in prevalence of anthraco-silicosis and hookworm have been especially striking.

The present paper is a long-term postoperative follow-up of 15 of the 17 cases of adrenal medullary hyperplasia (AMH) reported in 1977. Two patients from abroad were lost in the fo!low-up. Of the 15 cases, six were followed for 7-10 years, four for 10-15 years and 5 for more than 15 years. Seven cases showed marked improvement after operation with normal blood pressure in 4 and occasional hypertension in 3. Five patients showed definite improvement but with blood pressure above normal or with occasional attacks of hypertension. Three patients were not benefited by the operation. One patient died of cerebral hemorrhage 12 years after operation with remission of symptoms in the first 8 years. Two patients did not show any response to the operation and one of them developed cerebral thrombosis 2 years after operation. Recent check up of 15 cases, including relevant laboratory tests, indicated diabetes mellitus in 3. None of the cases showed evidence of multiple endocrine neoplasia. Our cases were compared with 15 cases of simple AMH and 19 cases AMH of multiple en docrine neoplasia Type II (MEN II) reported in the literature. A study of the incidence or hypertension. adrenal pathology and geographic distribution showed definite difference between primary AMH and AMH of MEN II.

Radiologic findings in 1,239 cases of patent ductus arteriosus (PDA) proved operatively were discussed with reference to some diagnostic problems. The problems include infundibulum sign and its diagnostic significance, radiologic diagnosis of small PDA, radiologic manifestation of pulmonary arterial hypertension in PDA, postoperative evaluation of PDA, and the diagnosis of PDA in cases without typical continuous murmur.

When one has difficulty in distinguishing bladder cancer from radiation damage, close cooperation among specialists and follow up are of great importance for a correct diagnosis and appropriate treatment. Previous irradiation and infection of pelvic organs, the bladder in particular, are two of the important factors in producing radiation damage. The causes of misdiagnosis vary. If both cystoscopic and histologic appearances are very confusing, close follow up including careful cystoscopic observation and repeated biopsy is recommended other than a hasty diagnosis of cancer followed by intensive therapy.

Total glycosides (TG) extracted from the root of Tripterygium wilfordii Hook f (TW, Leigongteng 雷公藤), are used in 200 cases of dermatoses, including Sweet's syndrome, allergic angiitis, eczema, erythema multiforme, Behcet's disease, erythroderma, psoriatic arthritis, etc. The medication has effective therapeutic action and response is quick. TG does not have side-effects of steroid and there is no rebound phenomenon after discontinuance. It can be used in patients who are steroid dependent, steroid resistant or in whom steroids are contraindicated. TG is useful in immunologic and inflammatory disease because of its potent immunosuppressive and anti-inflammatory actions which are experimentally demonstrated. TG side-effects are less and milder than those of the TW crude drug. The commonest side-effects are disturbances of digestive system, but these subside spontaneously. Leukopenia occurs in a few patients. The leukocytes normalize soon after discontinuance of the drug. Caution should be paid in administering it to child-bearing age patients and pregnant women.

In this paper the prenatal diagnosis of inherited disorders, such as heritable metabolic disorders, connective tissue disorders, cystic fibrosis, muscular dystrophies, and hemoglobinopathies is reviewed and some of the major problems are examined. New techniques which are less invasive and safer, are also discussed.

The results of cytologic examination of 271 patients with orbital and blepharal lesions between 1973 and 1978 are presented. According to the morphological features of cytologic smears the lesions are grouped into benign tumor (27%), malignant tumor (20%) and non-tumorous lesions (53%). In 15% of the series cytodiagnosis was inconclusive. 67 were operated upon with a biopsy coincidence rate of 72%.