1984年 · 第97卷第09期

Experiments on the pyrimidine metabolism in Schistosoma japonicum demonstrated that labelled bicarbonate, orotic acid and uracil are all incorporated into the nucleic acids of worms. This indicates that carbamoyl phosphate synthetase II-aspartate carbamoyl transferase-dihydroorotase complex, dihydroorotate dehydrogenase as well as orotate phosphoribosyl transferase-orotidylate decarboxylase complex do exist in S japonicum. S japonicum possesses not only all the enzymes of the pyrimidine de novo pathway but also the capacity of salvaging the preformed pyrimidines. The effect of schistosomicides (niridazole and anoscanate) on the pyrimidine de novo pathway in vivo has also been studied. It is suggested that the orotate phosphoribosyl transferase (orotidylate decarboxylase complex) is a vulnerable point which might be attacked by chemotherapeutic agents. The adenosone triphosphatase of tegument in S japonicum has been investigated. The specific activities of male and female worms were 17.3±3.8 and 17.0±2.5 μ moles Pi/hr/mg protein at 37 C respectively, and the km of the former was 6.25×10-4M. Mg++ and Mn++, could activate the tegumental ATPase markedly, whereas Ca+ did exhibit a weak stimulatory effect. The tegument was also capable of decomposing ADP, AMP, GTP and B-glycerophosphate to various extent.

This paper reports morbidity of endemic cretinism in endemic areas of 3 agricultural communes in southeastern and southern Guizhou. They were 3.1%, 2.8% and 5.2% in 1979. Retardation of physical development before 7 years of age is seen. Thyroid gland biopsy shows hyperplasia; point patches are scattered in scans and γ-scintiscans and there are cold and warm nodules. The surface area of thyroid gland is either normal, decreased or increased. There is mental retardation in all patients. The deaf-mutism or cerebral palsy is a characteristic of neural deficit. The roentgenographic features are delayed bony age and late ossification center of the femoral head. In this group iodine uptake of thyroid gland is increased apparently, urine iodine 25 μg/gm cretinine, serum T4 4.1 μg/dl, TSH 36.3 μU/ml. This group shows both severe psychoneurologic defects and evident hypothyroidism without myxedema, and is classified as the so-called mixed type of cretinism.

A comparative study on the results of 442 patients with hyperthyroidism from January 1960 to December 1979 was carried out and evaluated. The long-term (average 10.5 years) cure rate was 41.6%, 53.4% and 94.6% in three groups of antithyroid medication, radioactive iodine treatment and surgical procedure respectively. In the medication group, the recurrence rate (58.4%) was higher than that of the other two groups, while in the 131I treatment group, the incidence of hypothyroidism was the highest (23.3%). We incline to the view that surgery is the treatment of choice for thyrotoxicosis even if those patients recurred after operation.

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%.

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.

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.

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.

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.

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.

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.