1985年 · 第98卷第03期

A series of 15,696 cardiac patients admitted to our two hospitals were studied for changes in etiologic types of heart disease in the past 32 years. They were divided into 3 groups representing roughly cases seen in the 50's, 60's and 70's. Heart disease accounted for 9.8%, 15.69% and 20.9% of all admissions respectively. The frequency of common etiologic types was in the following order: In the 50's, theumatic heart disease (RHD), hypertensive heart disease (HHD), syphilitic cardiovascular disease, chronic pulmonary heart disease (PHD), coronary heart disease (CHD), congenital cardiovascular disease (CCD), thyroid heart disease and pericarditis; in the 60's, RHD, CHD, CCD, PHD, HHD, syphilitic cardiovascular disease, cardiac arrhythmia of undetermined cause, pericarditis and myocarditis; and in the 70's, CHD, RHD, CCD, PHD, myocarditis, cardiac arrhythmia of undetermined cause, HHD, idiopathic cardiomyopathy and pericarditis. RHD ranked first among the etiologic types in all the 3 decades. However, the percentage declined tremendously in the 70's and its leading position was substituted by CHD in the past 4 years. PHD was common and had a steady percentage throughout the 3 decades. Prevalence of hypertension was in creasing in the past 2 decades whereas HHD disease became less common in the 70's. Possible causes of the foregoing changes are discussed.

This is a prospective collaborative study on the perinatal mortality rate and cause of perinatal death in 11 cities in Jiangsu Province for the year ending in August 1981. Of the 86,913 perinatals born during this period, there were 2,131 deaths, including 1,140 stillbirths and 991 early neonatal deaths, with a perinatal mortality rate of 24.52. Causes of perinatal death were hypoxia (37.47%), respiratory disturbance (24.96%), congenital anomaly (11.29%), birth trauma (8.5%), low vitality (6.11%), miscellaneous causes (5.33%) and unknown (6.25%). From the causes mentioned, it is clear that prevention of hypoxia and respiratory disturbances, which caused 62.43% of the total perinatal deaths, is of major importance. Setting up facilities to detect congenital anomalies and determine fetal maturity would further lower perinatal mortality. Improving fetal monitoring and choosing the proper methods of delivery would be final steps in safe guarding the health of new borns.

26 cases of rupture of intact, unscarred uteruses during labor were analyzed. The tissue in rupture margins was studied pathologically and compared with biopsies of tissue from incision margins of cesarean sections done for impending uterine rupture or full-term and post-term gestation. Irreversible cell injury of fibers of the lower uterine segment, impaired by severe and longstanding pressure of fetal presentation during obstructed or prolonged labor was the essential pathophysiologic change of uterine rupture during labor. The pathophysiologic mechanism of uterine rupture during labor is based upon the pathologic findings and clinical data.

33 cases of Turner's syndrome confirmed clinically and pathologically are analysed. Laparoscopy and biopsy of the ovaries were performed in nine. X-ray appearance of Turner's syndrome could be divided into 2 groups: relatively characteristic and non-characteristic findings. Relatively characteristic findings included enlargement and squaring of the medial tibial condyle, with beak-like projection or fish hook like exotasis; shortening deformity of the metacarpals, phalanges, metatarsals and phalanges; cubitus valgus; delay of skeletal maturation and development deformity of the urinary system. The relation of Turner's syndrome cytogenesis to the X-ray findings was discussed.

Twenty five patients with systemic lupus erythematosus (SLE) treated with acupuncture are preliminarily reported. Among them 10 without previous corticosteroid therapy were treated with acupuncture alone and 15 including 12 with nephrotic syndrome having received large corticosteroid doses for more than 5 months with no effect were treated with acupuncture with gradually decreased corticosteroid. Well-matched controls were also followed. There was considerable improvement of symptoms and signs, laboratory findings and immunologic changes after acupuncture treatment. This suggests that simple acupuncture therapy might be of value in SLE.

The serum zinc level and urinary zinc output before and after an operative trauma of moderate severity were investigated. The serum zinc concentration dropped markedly 6 hours after operation in both zinc supplemented and not supplemented groups, and both gradually returned to near-normal. Provision of therapeutic dose of zinc did not prevent such reduction of the serum zinc level, but its speed of normalization quickened. The possible mechanism of this change is redistribution of available zinc in human being.

In this study the sera from a patient with macro-globulinemia were collected, IgM purified by salting out and gel filtrating with Sephadex G-200, and the heavy and light chain isolated by chemical-reduction. Antibodies to the μ chain were prepared by rabbit inocualtion. The immunodiffusion test showed that the μ chain combined with antibodies to human IgM, but not with Kappa and Lambda antibodies. The U chain antibodies were used clinically to detect anti-HBc-IgM, and the results obtained were similar to those of imported products.

This article deals with the relationship of the clinical types of hepatitis B with HLA-A and B loci and refers to the definite rule between them. The result of HLA-A genotype distribution among these groups had a marked significance (X2>3.84) such as increased Ag frequency in chronic active hepatitis group in comparison with healthy controls. The HLA-A3 and A28 were also closely associated with chronic active hepatitis. The HLA-A28 and B13 loci were higher in acute hepatitis group than the healthy controls. In the carriers, the chronic persistent hepatitis and the posthepatitis cirrhosis groups, the difference was not statistically significant (X2<3.84).

A most sensitive method was developed for the detection of Epstein-Barr (EB) virus in throat washings. Cryopreserved preparations of fetal cord blood lymphocytes, from samples already found to be optimally sensitive to virus-induced transformation in vitro, were exposed to concentrates prepared from throat washings by ultracentrifugation; the cells were then cultured for 8 weeks to observe the incidence of EB virus-induced transformation to lymphoblastoid cell lines. By this method, oropharyngeal shedding of EB virus was monitored in a prospective study involving 30 healthy adults (all but one of Caucasian origin) with serologic evidence of previous EB virus infection. Of these individuals, 6 shed virus on every occasion of testing within 15 months, 13 on most occasions, and 9 on less than half the occasions, while only 2 never gave evidence of virus shedding. This work indicates that the extent of EB virus shedding in healthy seropositive individuals is much greater than what previous reports have suggested, and raises the possibility that EB virus may actually persist in vivo via chronic, usually low-grade, replication in a permissive cell type in the oropharynx.