1978年 · 第N4卷第04期

During a 2 year period ending Dec. 1976, community control of hypertension, stroke and coronary heart disease was established in the Shihchingshan People's Commune in Peking's western suburb. The prevalence rate of hypertension in people over 15 years of age was 7.22%. 322 patients with hypertension were given drug therapy with satisfactory response in 96.9%. Screening for coronary heart disease was made in 3,820 persons over 40 years of age and a diagnosis of CHD was established in 150 cases, yielding a prevalence rate of 3.93%. With effective control of hypertension, mortality rate of stroke dropped from 273.41/100,000 in 1974 to 112.59/100,000 in 1976. Cardiovascular emergencies, such as in the health station of the production brigade or in peasants' homes with satisfactory result by barefoot doctors under the guidance of physicians of the mobile medical team from urban medical institutes.

Since February 1975, 53 cases of subacute hepatic necrosis due to acute virus hepatitis have been treated at the authors' hospital. 14% of these cases had hemoptysis and 24 had coma of over II degree. All cases were treated with combined therapy of traditional Chinese and western medicine. There were 13 deaths. Among the 40 patients who survived, 7 had coma of II-IV degree before treatment. The good results of this combined treatment are attributed to judicious use of traditional drugs given individually varying from patient to patient and careful selection of cases for corticosteroid therapy based on reaction to an in-vivo skin test by PHA.

Schizophrenics symptoms, subtypes and response to treatment vary during prolonged courses of illness. Comparing first and last hospitalization data of 100 cases with histories of over 10 years, we found that the mental syndrome concordance rate in two groups of cases was 45.0%-86.4%. Incidence of apathy and personality change rose to 65.0% and 70.0% from 38% and 22%; the coincidence rate in subtype diagnosis was 32%, 2/3 of which subsequently turned into mixed type. Response to therapy is probably related to variations in syndrome because immediate response to therapy worsened. The cause and mechanism of these variations need further study.

The incidence of pelvic fractures is quite high among earthquake casualties with a high incidence of complications and concomitant injuries. The medical mission while treating victims of the Hsingtai earthquake saw 2 cases of combined fracture and dislocation of the anterior and posterior pelvic ring reduced accidentally after being carried on the back by rescuers. Inspired by this serendipity, all the hospitalized pelvic fracture cases of the Hsingtai and Tangshan earthquakes were intensively studied. The authors discovered that the mechanism of fracture and displacement was somewhat different from that described in the literature. The Outstanding feature in most cases was inward rotation of the fractured half ring, so traditional treatment by Watson-Jones postural reduction or pelvic sling might only aggravate displacement. A manipulative reduction technique was devised and practised successfully. Fractures of the anterior pelvic ring were satisfactorily treated with early ambulation and combined traditional and western medicine.

From January 1963 to December 1972, 493 cases of retinal detachment were treated. Of these, 396 cases (80.3%) were reattached at discharge. Human skin was used as implant material in 389 cases for shortening of sclera, external buckling over full thickness of sclera, and encircling of the eye. 14 of the 389 cases presented early reactions postoperatively: which subsided following proper management. The retina was reattached at discharge in 10. Follow-up of 35 cases with skin implantation (17 for less than 3 years, 13 for 3-6 years and 5 for more than 6 years) showed no obvious late complications. It is considered that human skin preserved in 75% alcohol is a comparatively ideal implant material for retinal detachment surgery.

A follow-up study with special reference to sinus histiocytosis (SH) in the axillary lymph nodes was made in 95 cases of breast cancer which underwent Halsted radical mastectomy 10-23 years ago. Findings in the present series indicated that positive correlation existed between the reactivity of SH and the 10 years survival. The 10 year survival rate of patients with different SH gradings (0-III) was as follows: 0-29.3% (12/41), I-50.0% (9/18), II-81.8% (18/22), and III-78.6% (11/14). Of interest is that the favorable influence of SH upon the postoperative prognosis was particularly prominent in both the group with positive lymph node metastasis and the group with breast cancer of nonspecific type. SH is considered from the immunological point of view as a morphological representation of cell-mediated immunity of the host directed against cancer. In clinical practice, SH response can be used as one of the parameters to indicate the state of immunity of the patient and also as an indicator to predict the possible outcome.

This paper presents the results of 125I-T3 plasma binding ratio test for assessment of thyroid function, the test was done in 160 cases of whom 44 were normal subjects, 38 hyperthyroid (including 29 before therapy and 9 euthyroids after antithyroid drug treatment, 131I or thyroidectomy), 9 hypothyroid, 20 pregnant women and 49 women on oral contraceptive. The data of this series indicated that taking the mean value of the normal group ±1.6 S.D. (i.e., 0.83-1.15) as its upper and lower limits, the percentage of agreement of the normal, hyper and hypothyroid groups, are 88.6%, 90.0%, and 77.8% with certain over-lappings. The percentage of diagnostic agreement of the 131I uptake rate is compared with that of the 125I-T3 plasma binding ratio both for the normal and hyper-thyroid groups. The diagnostic value and limits of the test in assessment of thyroid function were discussed.

Clinical studies of 187 and 144 cases of hydrofluoric acid, burns are reported. These burns must be thoroughly flushed with clean water immediately, then sodium bicarbonate and boric acid solution wet dressings are used. Afterwards oleum Lithospermi compositum and fludrocortisone ointment are applied. Calcium iontophoresis can relieve pain immediately. In cases with blisters and tissue necrosis, debridement is necessary. For severe burns, calcium agents and steroids should also be given. The paper summarizes the causes of such burns and suggests some protective measures.

The external stabilizing tractor is a newly developed apparatus for correcting chest deformity and especially paradoxical respiration in flail chest. It is simple and easy to handle. The wounded may be safely transported with it in position, making continuity of treatment possible while travelling. This makes the apparatus particularly valuable in treating casualties at the front. The structure and method of application are described in detail.