Volume 95  ·   Issue 06  ·  1982

2 cases of cervical cytomegalovirus infection are reported with a review of the related literature. The possible reasons for the rarity of this disease in gynecologic and obstetric pathology a.re discussed in some detail.

The clinical course, laboratory findings, cytochemical studies and ultrastructural observations of 22 subacute myelogenous leukemia (SML) cases are reported and compared with those of 28 acute myelogenous leukemia (AML) cases. There were marked differences between the 2 groups. The most characteristic finding in our group is the morphologic feature of the leukemic cells which showed asynchronous development of nucleus and cytoplasm, large and marked nucleoli and deformed nuclei with spongy and swollen chromatin. We consider such cases a special type of myelogenous leukemia and call them SML since their natural course lies in the middle between AML and chronic myelogenous leukemia (CML).

A partially purified hepatitis A antigen (HAAg) was derived from feces of 10 children with type A hepatitis. IgG was extracted from sera of the patients during convalescence. The methods of direct electron microscopy (DEM), immune electron microscopy (IEM), microcomplement fixation (MCF), immune adherence hemagglutination (IAHA) and solid phase radio-immunoassay (SPRIA) were used successfully for identifying HAAg and antibody. The partially purified antigen and antibody were completely cross identified and confirmed to be hepatitis A antigen and antibody. The advantages and disadvantages of IEM, MCF, IAHA and SPRIA are also discussed.

40 cases of duodenal ulcer were treated by highly selective vagotomy (HSV) without gastric drainage. There were no mortality and severe complications. The average basic acid output decrease was 74.2% and 1 case had an early positive Hollander test within 2 weeks postoperatively. Excellent and good results (Visick I, II) were obtained in 87.5% of the cases. Ulcer symptoms recurred in 1 (2.5%) 1.5 years after operation. Temporary dysphagia occurred in 25% of the cases. The authors consider that HSV is the operation of first choice for uncomplicated chronic duodenal ulcer.

This paper introduces the psychiatric service development in China with respect to its historical background, including establishment of the extramural hospital mental health care system, paramedical and medical personnel training system, recreational, occupational and home therapy system. This form of psychiatric service is characterized by integration of treatment, relapse prevention and rehabilitation.

A short review of the history of the development of BCG vaccination in China from the early 30s onward is presented. Since its advent 6 decades ago, remarkable progress has been made in the elaboraton of basic BCG theories and clinical practice thanks to extensive research work carried out by medical men around the world. Honorable mention should be made of the tuberculosis, experts and control workers in our country, due to whose unstinting efforts BCG has taken root and borne fruit in this country where tuberculosis once was a dread disease. More recently we are happy to witness the bright prospects of an increasingly important role for BCG in cancer immunology. Divergent views exist in medical circles as to the theories and application of BCG in the drive against tuberculosis. Much useful work is being done by scientists over the world to further investigate and experiment with BCG in the untiring quest for man's well-being.

This article summarizes the results of thyrotropin releasing hormone (TRH) stimulation test done on 118 subjects since 1976. The responses are classified into 4 groups: normal, active, low and no response. 30 normal medical workers received 2 doses of TRH 0.5 and 1.0 mg, and 17 cases of untreated Grave's disease all showed no response. Four cases treated with antithyroid drugs gave active responses, 2 of them presenting manifestations of hypothyroidism, but in the other 2 no response was seen during the test. One case of autonomous hyperfunctional adenoma with T-3-hypertoxicosis gave a low response. 12 of the 13 untreated cases of primary hypothyroidism gave active responses, 1 had normal response. 2 of primary hypothyroidism with desiccated thyroid during substitution therapy gave no responses. In 13 secondary hypothyroidism cases, 3 gave normal responses, 1 low response and the remaining 9 no response. Effect of TRH test of various drugs was also observed. Among the 14 cases treated with adrenal glucooorticoids 6 gave no responses and 4 each gave normal and low response. 6 of 9 cases of parkinsonism treated with L-dopa showed no response, 2 normal response and 1 low response. Among 15 women receiving steroid contraceptives (compound quinoestrol) 10 showed active response and 5 normal response. Clinical significance, dosage and side effects of TRH test and factors influencing it are discussed.

This paper reports the prevalence of diabetes mellitus (DM) in 14 provinces and large cities of China, which has been extensively investigated since 1980 under the auspices of Ministry of Health supported by the provincial Health Bureaus. 304,537 subjects were investigated, about 8570 were the Han nationality and the others were minority nationalities including Moslems, Mongolians, Tibetans, Miaos, Zhuangs and Uigurs. On excluding 10,358 Uigurs and using the screening method and diagnostic criteria proposed by the National Diabetes Research Co-operative Conference held in Lanzhou in 1979 and amended in Beijing in 1980, 899 overt DM (2.96‰) and 955 chemical DM (3.15‰) cases were diagnosed, a 6.09‰ prevalence rate. The standardized prevalence is 6.74‰ according to the 1964 population. Prevalence varied markedly from one district to another, ranging from the highest in Ningxia (10.62‰) to the lowest in Guizhou (1.51‰). The standardized prevalence is highest in Beijing (11.04‰) and lowest again in Guizhou (1.56‰). Among 160,195 males standardized prevalence is 6.84‰ and among 144,342 females 6.62‰, a male to female standardized ratio of 1.03, males being slightly more affected. However, on excluding influencing factors other than sex, there is no statistically significant differeaice, p>0.05. So both male and female subjects are equally affected in China, which differs from adult DM female predominance in foreign countries. Though DM prevalence varies widely, the general tendency for it is to be higher in urban than rural areas. In general, DM prevalence is comparatively lower in China than in many other countries. It is closely correlated with age, sex, body weight, occupation, nationality and regional factors. All these can be considered as intrinsic and extrinsic factors of DM pathogenesis and further intensive. research is required.

Relatively rare carotid body tumors are reported. 60 of 63 cases are treated surgically. The condition is difficult to diagnose worldwide and the most reliable diagnostic method is arteriography. Partial tumor excision is negated as the residual tissue invariably proliferates, complete tumor excision with autogenous vein graft when necessary is the treatment of choice. Of major importance in this tumor are measures to decrease cerebral complications, principally hemiplegia, following ligation of the common or internal carotid arteries. Thorough knowledge of collatetral cerebral circulation and measures to increase it before operation are mandatory. Pancerebral angiography and ultrasonography to assess internal carotid artery blood flow plus Matas' test to evaluate and promote collateral cerebral circulation are vital preoperatively.

The pathogenesis of portal hypertension is not entirely clear. Mechanical obstruction to the portal vascular beds and increase of portal blood flow have been considered important factors implicated in the elevation of portal pressure. Previously the authors had found that the height of portal pressure is closely related with the state of liver function. Therefore liver function deterioration may be accompanied by disturbance of the liver enzymatic system and metabolism of some humoral substances may be impeded resulting in an accumulation of these substances in the blood. In this study, the effects of histamine, norepinephrine, dopamine and glucagon on liver hemodynamics are studied. It is found that all these 4 substances can elevate portal pressure through different mechanisms. Histamine and norepinephrine increase portal resistance at different locations and dopamine and glucagon augment portal blood flow. Therefore, it is suggested that in addition to mechanical obstruction of the portal bed and increase of portal flow a "humoral mechanism" may play an important role in the pathogenesis of portal hypertension. If it is true, some drugs or antagonists may be used to combat this disease in addition to the conventional treatment.