1979年 · 第92卷第06期

A case of crushed amputation of the left upper arm complicated by liver rupture was successfully treated and followed up for more than 2 years, there was good recovery. Any traumatic amputation patient with shock and organ injury must be examined thoroughly and correct diagnosis made as soon as possible. Wound debridement must be thorough. Replantation should only be performed on the basis of safety and integrity of the severed limb. Successful replantation depends on adequate management of blood vessels, proper prevention and treatment of complications and restoration of normal function.

During the past few years, 30 cases of generalized scleroderma have been treated by combined traditional Chinese and western medicine. The results were satisfactory in all but 2 cases. The therapeutic method and drugs are described in detail.

Two cases of acute clonorchiasis are reported. The incubation period was 10 and 26 days respectively after eating raw fresh water fish harboring Clonorchis cysts. Their clinical manifestations were characterized by loss of appetite, anorexia, epigastric pain, diarrhea, marked leucocytosis with high eosinophilia, elevated ESR and marked changes in GPT, gamma-glutamyl transpeptidase and alkaline phosphatase. Such cases may easily be misdiagnosed as acute hepatitis. The diagnosis in both cases was suggested by the history of having eaten raw fresh water fish in endemic area, positive skin test and serum complement fixation test for clonorchiasis and was finally confirmed by the presence of Clonorchis ova both in stool and bile. Both patients were cured with hexachloroparaxylol combined with furapromidium.

Keshan disease (KSD), an affection of myocardium characterized by myocardial necrosis and scar formation, was first discovered in 1935 when an outbreak of the disease occurred in Keshan county, Heilongjiang province, northeast China. Its etiology is still unknown. One hypothesis is that KSD is a distinct disease of clinical entity with a very strict geographical distribution and that therefore its indispensable causative agent should be looked for in the endemic areas. Basing himself on the epidemiologic, pathologic and clinical manifestations of KSD detailed in this report, the author is inclined to the belief that the disease is a form of viral myocarditis that ends with severe manifestations, its indispensable causative agent being virus of ubiquitous nature capable of causing myocardiopathy, and that in addition there are some contributory factors predisposing the population in endemic areas to a kind of clinical infection that severely affects the heart.

The results of radioactive isotope examinations (B/K ratio, renogram and renal scanning) in 2 cases of renal allograft during acute rejection reaction are reported. Their diagnostic values are compared with those of blood urea nitrogen and creatinine determinations as well as with the clinical symptoms and signs of renal transplant rejection. The significance and mechanism of radioactive isotope examination in renal allograft are discussed.

The clinical records of 132 cases of nephroblastoma (Wilms' tumor) admitted to the Beijing Children's Hospital in the past 21 years (1956-77) are analysed with special reference to urographic changes. Five different types of urographic manifestations not previously reported in the literature are listed which correlate well with the operative findings and the stage of pathologic process. Through a careful study of the urographic manifestations, it was considered possible to make preoperative diagnosis on the stage of the disease process and consequently to arrange for appropriate treatment. The various aspects of differential diagnosis between Wilms' tumor and other retroperitoneal tumors such as neuroblastoma, teratoma, multicystic kidney and hydronephrosis are also discussed in this report.