The crying pulmonary function of 46normal children and 61 children with pneumonia under 2 years of age was measured with the pneumonometer connected with an electrocardiograph. The measurements included the crying vital capacity (CVC) , peak inspiratory flow (PIF) and peak expiratory flow (PEF) . A positive correlation between the crying pulmonary function and the height was found, and on the basis of this correlation, the following regression equations are suggested: CVC=10.67 ht—496.87; PIF=1.94 ht—63.79;PEF=1.73 ht—60.60. CVC, PIF and PEF decreased in children with pneumonia and varied with their condition. The difference between them and normal children in these 3 items was very remarkable. The crying pulmonary function remained abnormal for a long time after the clinical symptoms had disappeared. We think that the crying pulmonary function test is a simple non-invasive method of measuring the pulmonary function in children under 2 years of age. It is also helpful in evaluating the effect of therapy and prognosis.
Of 8 pneumomediastinum cases, 5 were from 15 neonates with meconium aspiration pneumonia and 3 from 33 amniotic fluid aspiration pneumonia cases. All 8 infants had a birth weight above 2,800 g and a history of neonatal asphyxia. 6 babies were admitted within 9 hours after birth with the chief complaints of dyspnea and cyanosis. Pneumomediastinum was confirmed by chest film with the sign of elevated thymus.6cases were complicated by pneumothorax. The air was usually confined to the anterior mediastinum. Subcutaneous emphysema was not observed in these cases. Pneumomediastinum may cause neonatal death if not treated in time. A watersealed drainage of the affected pleural cavity should be done if the disease is associated with pneumothorax. If no improvement, decompression of the mediastinum must be performed promptly. Cervical incision for the release of trapped air is often not effective because the air in the mediastinum is seldom in a single compartment.
CSF lactate level was measured in 122patients (144 samples). The difference be tween controls ( = 10.84 mg/dl), non-CNS infection cases (= 14.07 mg/dl) and viral meningitis cases (= 16.48 mg/dl) was not statistically significant. In all these 3 groups, the CSF lactate level was lower than 30mg/dl except for one case of viral meningitis. In purulent meningitis it was highest (= 61.16 mg/dl). In patients with tuberculous meningitis the level of CSF lactate was significantly higher as compared with viral meningitis (= 37.38 mg/dl),but the level was lower - than the untreated purulent meningitis. The CSF lactate level of tuberculous and purulent meningitis cases were closely related with the duration and efficacy of treatment. Measurement of CSF lactate during the first lumbar puncture can be used as a tool for differential diagnosis of purulent, tuberculous and viral meningitis, especially the latter two. Dynamic observation is valuable in differentiation of purulent and tuberculous meningitis and can judge therapeutic effect. CSF pH was measured in 142 samples. Purulent meningitis patients had significantly low CSF pH.
Of 22 tuberous sclerosis cases 12 were male and 10 female. Their age ranged from 6 months to 17 years, with 21 under 10years. 4 patients had family history of the same disease. All the 22 cases had facial sebaceous adenoma for 2~17 years. Usually, they began in childhood and increased in incidence during puberty, distributed symmetrically along the nasolabia folds in a butterfly pattern with capillaries on the nodule. A plaquelike variety of sebaceous adenomas also occurred on the temple, forehead, neck and chest. Discolored macules were found on the back in 9 patients. 3patients had cafe-au-lait spots and neurofibromatosis on the back. Epileptic seizures and varying degree of mental retardation each occurred in 18 patients. 3 patients had headache, vomiting and papilledema due to chronic intracranial hypertension. 18 out of 21 had epileptiform abnormalities on their EEG. Of 7 cases having skull film taken, 3 showed intracranial calcifications. 4 cases had pneumoencephalogram, 3 of them showed intracranial calcification and ventricular dilatation and 1 had intraventricular tumor. CT scan of the head was done in 2 cases, 1 had symmetrically dilated ventricular system and the other calcification in ventricular wall and cortex. The treatment of this disease was symptomatic.
Of 20 cases of atrial flutter and atrial fibrillation in children, myocardial disease was the most common cause. Arrythmia and congestive heart failure were the main clinical features. No typical symptoms and signs were found in children. 8 cases had disturbances of the cardiac conduction system. The therapeutic effects of digitalis and electrical cardioversion were fairly satiafactory. Electric pacing should always be ready for use to prevent the danger of cardiac arrest if drug or DC countershock are attempted to terminate atrial flutter and atrial fibrillation.
8 cases of hemoglobin Bart's hydrops foetalis syndrome were studied, 5 male and 3 female. Duration of pregnancy was 30~40 weeks, body weight 1,000~3,500g (mean 2,000 g). 5 cases were born alive but died within 5~30 minutes after birth. 2 were stillbirths. The patients' parents were all from Guangdong Province except one mother from Hebei. Typical clinical features were observed in 7 cases' only one case had mild anemia. 7 cases had marked hepatomegaly, 4 cases had splenomegaly, 2 had slight jaundice and 1 skin ecchymosis. All cases had macro-placenta, weighing 1,100~1, 700 g (mean 1, 570 g). Laboratory findings: hemoglobin 3 . 5~11 . 1 g/dl; reticulocytes 3.8~48.5% in 6 cases.All cases showed erythroblastosis and abnormal Thalassemia-like erythrocytes accompanied with hypochromic macro-erythrocytes. Sickling test and isopropanal test were positive in 6 cases. Hemoglobin Bart's concentration was 80.6 ~90.4 % , hemoglobin portland 9.6~19.4% and alkali-resistant hemoglobin 32.2~76.0 %. Postmortem study of 6 cases revealed extramedullary erythropoiesis. Patients' parents were shown to be heterozygous α-Thalassemia 1. The father of 1patient and the mother of another case probably were double heterozygous α-Thalassemia 1/β -Thalassemia. The mothers of 6 cases suffered from toxemia of pregnancy and of 2, hypertension of pregnancy.
The symptomatology of 34 virologically proved type 11 adenovirus pneumonia cases was reported. Of these,32 were compared with 197 cases of types 3 and 7adenovirus pneumonia. In 22 cases under 2 years of age, the onset was abrupt with sustained high fever, listlessness, lethargy, pallor and cold extremities, followed by dyspnea and cyanosis on the third to sixth days. 17 cases had dullness and 5 tubular breath sounds on chest examination. Heart failure developed in 2 cases and edema in 1. WBC was slightly lower than normal. Roentgenologically, two fifth of the cases had patchy or coalescent shadows in the left lower or both lower lobes. Serious or fatal cases accounted for 20.6%. The number of critically ill cases was less than that of type 7 and type 3.
From the winter of 1978 to the spring of 1980, 65 cases of sclerema were investigated in the hospital. They were randomly distributed into two groups, the heparin treated group and control group. On top of the general supportive treatment, heparin was added to the former group in doses of 1~2 mg/kg every4~6 hours intravenously and continued until the platelet count and coagulation test returned to normal and sclerema disappeared. 13 parameters were taken to assess the heparin efficacy. It was found that heparin is beneficial to neonates with sclerema neonatorum. In addition to the effect of preventing hemorrhage, heparin may shorten the time needed for rewarming the baby and promote disappearance of sclerema. It also decreases the mortality. These effects are attributed to its anticoagulative action, which decreases the blood viscosity, accelerates blood flow and thereby improving the circulation.
From 1973 to 1980, investigations of adenovirus types 3 and 7 infection were carried out in the winter and spring in Wuhan. The virus isolation rate was 19.8%in children with pneumonia. Direct immunofluorescence tests on throat swab smears revealed a positive rate of 29.3%, Paired sera 4-fold rise in antibody titers of HI test was 34.4%. These showed that adenovirus types 3 and 7 pneumonia are common in Wuhan. Clinical manifestations consisted mainly of dyspnea, nonproductive cough and neuropsychic symptoms. Although the disease is rarely serious, it may involve all systems of the body. Damage to the heart muscle may be fatal. Typecross reactions need to be eliminated for rapid diagnosis of adenovirus infection by means of direct immunofluorescence test.
= 10.84 mg/dl), non-CNS infection cases (
= 14.07 mg/dl) and viral meningitis cases (
= 16.48 mg/dl) was not statistically significant. In all these 3 groups, the CSF lactate level was lower than 30mg/dl except for one case of viral meningitis. In purulent meningitis it was highest (
= 61.16 mg/dl). In patients with tuberculous meningitis the level of CSF lactate was significantly higher as compared with viral meningitis (
= 37.38 mg/dl),but the level was lower - than the untreated purulent meningitis. The CSF lactate level of tuberculous and purulent meningitis cases were closely related with the duration and efficacy of treatment. Measurement of CSF lactate during the first lumbar puncture can be used as a tool for differential diagnosis of purulent, tuberculous and viral meningitis, especially the latter two. Dynamic observation is valuable in differentiation of purulent and tuberculous meningitis and can judge therapeutic effect. CSF pH was measured in 142 samples. Purulent meningitis patients had significantly low CSF pH.
