Outpatient clinic treatment of broncho-obstructive syndrome using an artificial regulator of respiration

The artificial respiration regulator (ARR) employed by the authors belongs to the series of analogous apparatuses rendering resistance to expiration and preventing hyperventilation in broncho-obstructive syndromes. The device used is more compact and simple in management. It promotes improvement in the condition of patients with severe forms of bronchial asthma and chronic bronchitis complicated by expiration, stenosis, permits discontinuation of drugs and hormones in the majority of patients. ARR is believed efficient in the outpatient treatment of broncho-obstructive syndrome.     

Clinicofunctional features of arterial hypertension in chronic broncho-obstructive syndrome

AIM: To describe clinicofunctional features of essential and pulmogenic hypertension in chronic bronchoobstructive syndrome, 24-h profile of arterial pressure (AP), intracardiac hemodynamics and to propose differential diagnostic criteria for these hypertension forms. MATERIALS AND METHODS: 24-h monitoring of arterial pressure (MAP), cardiohemodynamics, external respiration function (ERF) and blood gases examinations were made in 100 hypertensive subjects with chronic obstructive bronchitis and bronchial asthma. RESULTS: Significant differences were found between the groups of essential and pulmogenic hypertension by major values of MAP, echo-CG and ERF. Early disturbances in diastolic function of both the ventricles in essential and pulmonary hypertension in chronic bronchial obstruction arise long before clinical, x-ray and ECG signs of chronic pulmonary heart. CONCLUSION: The findings enable formulation of criteria of differential diagnosis of essential and pulmogenic hypertension and identify the latter as an independent nosological entity.     

Various problems of the diagnosis and therapeutic tactics in systemic lupus erythematosus

The authors discuss diagnostic aspects of systemic lupus erythematosus (SLE) with emphasis on its early stages and outpatient policy. Formalized diagnostic criteria of the disease are recommended. Clinical features of the variants of SLE onset are briefly reported. Various aspects of the patients' management and regime, limiting measures are considered for a confirmed and tentetive SLE diagnosis.     

The broncho-obstructive syndrome in adolescents as a stage in the development of chronic bronchitis

As many as 544 adolescents (268 boys and 276 girls) were examined. Using pneumotachometry and spirography, bronchial patency disorders were identified in 19.8 +/- 2.4% of normal adolescents with no factors at risk for chronic nonspecific pulmonary diseases, in 41.2 +/- 4.2% of patients with acute respiratory virus infection (ARVI), in 54.0 +/- 5.3% of tobacco smokers, in 44.7 +/- 8.1% of patients who frequently fall ill with ARVI, acute bronchitis and pneumonia, and in 50.0 +/- 12.5% of patients afflicted with grade II scoliosis or kyphoscoliosis of the thoracic vertebrae. In normal adolescents without risk factors, distal disorders of bronchial patency were encountered in 5.6 +/- 1.4% of cases, in ARVI patients in 7.4 +/- 2.2%, and in tobacco smokers, in 18.4 +/- 4.2% of cases. In a lot of adolescents, the broncho-obstructive disorders were steady in nature, dictating the necessity of carrying out the treatment and health measures. Pneumotachometry may be recommended for detecting bronchial patency disorders during prophylactic examinations of adolescents.     

黑斑息肉综合征6例并文献复习

目的 探讨黑斑息肉综合征（Peutz-Jeghers syndrome ,PJS）临床诊治。方法 回顾性分析1995年~2007年我院治疗的6例PJS患者的临床资料。结果 6例患者均有不同程度的口唇、颊粘膜等部位黑色素沉着斑，并有胃肠道息肉。6例均接受多次内镜治疗, 本组患者中有1例因小肠梗阻接受急诊手术，术后行肠镜摘除结肠息肉, 1例因长期便血行肠镜检查发现结肠息肉癌变行结肠癌根治术。结论 内镜治疗是PJS患者息肉的首选，内镜摘除息肉困难或合并肠梗阻、出血等情况，考虑手术治疗，术后定期行消化内镜或钡餐检查，及时发现复发情况。     

痴呆患者诊疗中应重视的几个问题

目的:论述目前痴呆诊疗工作中存在的、需引起重视的问题,为更准确和合理的进行痴呆临床诊疗工作提供参考。资料来源:应用计算机检索Medline数据库1992-2005有关痴呆、痴呆临床诊疗及其存在的问题的文章,并限定文章语言种类为English;应用计算机检索中国期刊网数据库2002-2004有关痴呆的治疗及其治疗对认知功能影响的文章,限定文章语言种类为汉语,检索词为痴呆、认知障碍、诊断。资料选择:对资料进行初审,排除文献中重复的研究和Meta分析类文章,选取符合要求的有关文献,并查找全文。资料提炼:共收集到15篇有关痴呆临床诊疗及其存在的问题的文章,排除重复或类似的研究,纳入12篇。资料综合:痴呆疾病是一组以认知功能障碍为特点的临床综合征,痴呆的病史是进行初步病因诊断和疾病分类重要的临床诊疗项目,但在有些痴呆病的发病初期认知功能障碍多不明显,以精神症状为首要表现,临床中特别要对痴呆伴有抑郁和抑郁引发假性痴呆给予正确鉴别。痴呆治疗的方法主要包括病因治疗、生物学治疗、心理治疗等,而在生物学治疗中药物的选择上要注意药物的种类及毒副作用等。为了解患者不同性质、不同部位的病损,不同病程时的心理变化以及仍保留的心理功能等情况,需使用各种神经心理学量表,而量表的评价结果仅能作为痴呆的首选诊断,而不是最终诊断。结论:痴呆的病史及发病初期的精神症状均可影响其诊断效果,在痴呆临床诊疗中,应拓宽临床视角,在使诊断指标量化的同时注意患者的个体化特点,以不断提高临床痴呆诊疗的准确性和系统性。     

痴呆患者诊疗中应重视的几个问题

目的：论述目前痴呆诊疗工作中存在的、需引起重视的问题,为更准确和合理的进行痴呆临床诊疗工作提供参考.资料来源：应用计算机检索Medline数据库1992-2005有关痴呆、痴呆临床诊疗及其存在的问题的文章,并限定文章语言种类为English;应用计算机检索中国期刊网数据库2002-2004有关痴呆的治疗及其治疗对认知功能影响的文章,限定文章语言种类为汉语,检索词为痴呆、认知障碍、诊断.资料选择：对资料进行初审,排除文献中重复的研究和Meta分析类文章,选取符合要求的有关文献,并查找全文.资料提炼：共收集到15篇有关痴呆临床诊疗及其存在的问题的文章,排除重复或类似的研究,纳入12篇.资料综合：痴呆疾病是一组以认知功能障碍为特点的临床综合征,痴呆的病史是进行初步病因诊断和疾病分类重要的临床诊疗项目,但在有些痴呆病的发病初期认知功能障碍多不明显,以精神症状为首要表现,临床中特别要对痴呆伴有抑郁和抑郁引发假性痴呆给予正确鉴别.痴呆治疗的方法主要包括病因治疗、生物学治疗、心理治疗等,而在生物学治疗中药物的选择上要注意药物的种类及毒副作用等.为了解患者不同性质、不同部位的病损,不同病程时的心理变化以及仍保留的心理功能等情况,需使用各种神经心理学量表,而量表的评价结果仅能作为痴呆的首选诊断,而不是最终诊断.结论：痴呆的病史及发病初期的精神症状均可影响其诊断效果,在痴呆临床诊疗中,应拓宽临床视角,在使诊断指标量化的同时注意患者的个体化特点,以不断提高临床痴呆诊疗的准确性和系统性.     

Peutz-Jeghers综合征的诊治进展

Peutz-Jeghers综合征(peutz-jeghers syndrome,PJS)是一类少见的以胃肠道多发性息肉和黏膜黑斑为临床表现的综合征。病因尚不完全清晰,临床表现主要以消化道症状和皮肤黏膜色素沉着为主。诊断主要依靠患者临床表现及辅助检查。内镜检查常可发现胃肠道多发性息肉,基因检测常可发现丝氨酸/苏氨酸激酶11(serine/threonine kinase 11,STK11)或称肝激酶B1(liver kinase B1,LKB1)基因突变,诊断准确率高。对于PJS目前多为个案报道,尚缺乏系统性认识。我们对PJS的发病情况、临床表现、辅助检查及诊治与进展作一综述。     

The hyperventilation syndrome: the treatment problems

The principal methods of the treatment of the hyperventilation syndrome (HVS) are reviewed. The following methods of the action on the patient are distinguished: psychotherapy, pharmacotherapy, remedial gymnastics, correction of respiratory disorders according to the principle of the biological feed-back mechanism, recurrent respiration or carbon dioxide inhalations. Emphasis is laid on the importance of an individual approach to the institution of the treatment measures. The relationship between the HVS and respiratory diseases is discussed. The authors advance an opinion that every patient may note improvement after receiving a properly selected complex of the treatment measures.