Inverse variations of plasma renin activity and renin substrate in normal man

Abstract. In the control subject, plasma angiotensin production is a linear function of plasma renin content. Upon incubation of this same plasma in the presence of an excess of homologous renin, angiotensin production is finally limited by the plasma content of renin substrate (PRS). By this method, PRS levels were measured and compared with levels of plasma renin activity (PRA), urinary aldosterone excretion, and sweat sodium and potassium content, in sixteen normal human subjects, aged twenty-five to thirty years, under three defined metabolic conditions: unrestricted sodium intake, salt depletion, constant sodium intake plus administration of desoxycorticosterone acetate (DOCA). 1) Unrestricted Sodium Intake. In these control subjects, in perfect health, there exist important individual differences in PRS levels. The PRS levels seem to be quite constant for a given subject under a given metabolic condition: the levels remained the same after a four month interval for a given subject. 2) Salt Depletion. Activation of the renin-angiotensinaldosterone system (RAAS), as shown by an elevation of PRA and of urinary aldosterone excretion, is accompanied by a decrease in PRS levels. 3) Constant Sodium Intake Plus Administration of DOCA. Inactivation of the RAAS, as shown by lowering of PRA and of urinary aldosterone excretion, is accompanied by a marked elevation of PRS levels. It would appear that, in human control subjects there exists an inverse relationship between PRS and PRA levels.     

Malignant Hidradenocarcinoma in the Lower Extremity: A Case Report of a Rare Tumor

Malignant hidradenocarcinomas are rare soft tissue tumors of sweat gland origin. We present the case of a soft tissue, fungating tumor of 15 years' duration of the medial ankle in an 85-year-old male that exhibited malignant features clinically and radiographically. Subsequent punch biopsy revealed a diagnosis of malignant hidradenocarcinoma. Given the risk of recurrence and the poor radiation and chemotherapy options, the patient initially decided to leave the lesion untreated. However, he soon developed lower extremity cellulitis from the exposed lesion and decided to have the tumor excised, eliminating the source of the infection. In the present case study, we discuss the etiology, clinical and radiographic characteristics, and treatment options for this rare lesion. At the 18-month follow-up visit, he had had no recurrence of the lesion.     

犀角地黄汤治疗小儿过敏性紫癜临床观察

目的观察犀角地黄汤加减治疗小儿单纯型过敏性紫癜的临床疗效。方法选取2013年8月—2017年8月沈阳市中医院儿科60例单纯型过敏性紫癜患儿,随机分为治疗组和对照组,各30例。对照组采用西医常规治疗,治疗组在对照组基础上加用犀角地黄汤加减治疗。2组均以7 d为1个疗程,连续2个疗程后观察疗效。结果治疗组总有效率为93.33%(28/30),对照组为70.00%(21/30),2组比较差异有统计学意义(P<0.05)。结论采用犀角地黄汤加减治疗小儿单纯型过敏性紫癜能够明显提高治疗效果,促进症状缓解,安全可靠。     

Advances in the diagnosis and management of cystic fibrosis

Cystic fibrosis (CF), the most common lethal genetic disease affecting Caucasians, is a multi-system illness, most frequently characterized by childhood chronic obstructive pulmonary disease, pancreatic exocrine insufficiency, and abnormal sweat electrolyte concentrations. The diagnosis of CF is based on a combination of the above clinical findings and/or a positive family history of the illness in conjunction with an abnormal sweat test. The quantitative pilocarpine iontophoresis test is the sole acceptable method for diagnostic confirmation of the clinical suspicion of CF. A recent advance in the diagnosis of CF has been in the development of methods for neonatal detection. The immunoreactive trypsinogen (IRT) detection test is practical, adaptable to large scale screening of dried neonatal blood spots, relatively inexpensive, and promising for the detection of newborns with CF who have pancreatic insufficiency. However, the reliability and validity of this method have not yet been adequately established. Major advances in the treatment of patients with CF have emerged in the last decades, particularly in supportive pulmonary and nutritional care.     

急诊科夜班对护士心理健康的影响及分析

目的分析急诊科夜班护士心理健康情况,调查影响因素。方法选择我院急诊科夜班护士20名作为观察组,正常作息的健康人1338例作为对照组。采用症状自评量表SCL-90对其心理情况进行分析。结果观察组躯体化、强迫症状、人际关系敏感、焦虑、敌对、偏执因子评分均高于对照组,差异有统计学意义(P<0.05)。结论值夜班可影响急诊科护士心理健康状况。     

腋窝菌群敏感性与顶泌汗腺分布规律的研究

目的：探讨腋窝常见菌群的敏感性和顶泌汗腺的分布,为优化腋臭手术治疗方案,减少术后不良反应提供可靠依据。方法：术前取腋窝代谢物做细菌培养及药敏试验,在局部肿胀麻醉下,采用腋皱壁切口,切除腋浅筋膜浅面的顶泌汗腺治疗腋臭102例。取部分患者腋毛范围外0．5cm及腋毛中央切口皮肤标本送病理检查。结果：术后随访6～12个月,手术效果满意,总有效率97．5％。结论：根据顶泌汗腺的分布,采用合理的切开深度和分离范围修剪去除顶泌汗腺,使用敏感性的药物防感染治疗及妥善的术后护理,是保证腋臭手术成功,减少不良反应的关键。     

Sweat testing to evaluate autonomic function

Sudomotor dysfunction is common in many subtypes of neuropathy but is one of the earliest detectable neurophysiologic abnormalities in distal small fiber neuropathy. Clinical assessments of sudomotor function include thermoregulatory sweat testing (TST), quantitative sudomotor axon reflex testing (QSART), silicone impressions, the sympathetic skin response (SSR), the acetylcholine sweat-spot test and quantitative direct and indirect axon reflex testing (QDIRT). These testing techniques, when used in combination, can detect and localize pre- and postganglionic lesions, can provide early diagnosis of sudomotor dysfunction and can monitor disease progression or disease recovery. In this article, we describe many of the common clinical tests available for evaluation of sudomotor function with focus on the testing methodology and limitations while providing concrete examples of test results.     

Working at night and work ability among nursing personnel: when precarious employment makes the difference

Purpose  To test the association between night work and work ability, and verify whether the type of contractual employment has any influence over this association. Methods  Permanent workers (N = 642) and workers with precarious jobs (temporary contract or outsourced; N = 552) were interviewed and filled out questionnaires concerning work hours and work ability index. They were classified into: never worked at night, ex-night workers, currently working up to five nights, and currently working at least six nights/2-week span. Results  After adjusting for socio-demography and work variables, current night work was significantly associated with inadequate WAI (vs. day work with no experience in night work) only for precarious workers (OR 2.00, CI 1.01–3.95 and OR 1.85, CI 1.09–3.13 for those working up to five nights and those working at least six nights in 2 weeks, respectively). Conclusions  Unequal opportunities at work and little experience in night work among precarious workers may explain their higher susceptibility to night work.     

浅谈妇科汗证及治疗

汗为五液之一,正常的汗出有调和营卫、润泽肌肤、清除废秽等作用.汗证是指阴阳失调、营卫不和、腠理开阖不利而引起汗液外泄的病症,在妇科临床较为多见.通过对妇科痛证、血证、发热、产后以及更年期汗证的发生机理及其治疗的论述.总结出热证、实证类的汗出当予清泄;虚证类的汗出则予收敛和补益的治则.     

Idiopathic acquired anhidrosis: reversible generalized anhidrosis after sunstroke.

Idiopathic acquired generalized anhidrosis is a very rare condition in which the pathogenesis is still unknown. Although varied findings have been reported, no consistent abnormal findings in sweat glands have been established by histological study or electronmicroscopic study. An 18-year-old Korean boy suffered from generalized anhidrosis after sunstroke. Physical and neurologic examination could not reveal any abnormal findings. There were no specific changes in the sweat glands, but amorphous vacuole-like structures were seen in the cytoplasm of secretary cells. We reviewed the previous reports about this rare condition and compared them with our patient.