SOME CLINICAL OBSERVATIONS ON CASES OF KERATOMALACIA IN MANCHURIA

Certain diseases are sometimes very common m one country and yet very rare in other. Keratomalacia is one such. During my three years'' stay in Europe attending Dr. Sym''s Eye Clinic in the Royal Infirmary of Edinburgh, Scotland, Dr. Bickerton''s Oinic in Liver- pooj, England, St. Paul''s Eye Hospital and Dr. Meller''s Eye Clinic in Vienna, Austria, I saw only five cases of Kcratornalacia in children and none at all in adults. In Manchuria, however, the disease is not infrequcntly seen. During the last ten years, 1924 t0 1933, out of 34,470 eye patients, 1,003 0r 2.g per cent were diagnosed as Kerato- malacia.     

Acquired immunodeficiency syndrome with Kaposi’s sarcoma in Ireland

Two previously healthy white males, one homosexual, one bisexual developed acquired immunodeficiency syndrome (AIDS) with Kaposi's sarcoma. This syndrome has not previously been reported in Ireland. In view of the hight mortality, physicians here should be aware of the possible risk factors and necessary precautions.     

Galactorrhoea following surgical procedures to the chest wall: the role of prolactin.

Normal prolactin levels were found in two cases of galactorrhoea following surgical procedures to the chest wall and one was treated successfully with bromocriptine. Studies were then carried out to test the claim that chest-wall injury is one of the common causes of hyperprolactinaemia. Serum prolactin levels were measured before and after thoracotomy in 7 patients, following traumatic rib fractures in 8 patients and after burns to the chest in one patient. No evidence was found to suggest that sustained hyperprolactinaemia follows chest wall surgery or injury, and the role of prolactin in the condition ''chest wall injury'' galactorrhoea is discussed.     

通因通用法在哈氏妇科临证中的应用

哈氏妇科是全国中医妇科十大流派之一,传承已百年,临证凸显中医辨证论治、治病求本的特色,应用通因通用法治疗妇科疾病疗效显著。主要介绍哈氏妇科临证中以活血法治崩漏、理气法疗经行吐衄、化瘀法医产后恶露不绝等治疗妇科常见疾病,值得深入学习和推广运用。     

Captopril in hypertension after renal transplantation.

Eight hypertensive renal allograft recipients who had received captopril are presented. Captopril in a maximal daily dose of 250 mg enabled the withdrawal of large doses of beta-blocking agents and vasodilators. Blood pressure was satisfactorily controlled in all except one. No adverse side effects were observed other than the ''first dose'' effect which resulted in transient anuria in one patient. Captopril appears to be a useful agent in the management of severe hypertension after renal transplantation.     

WORK SCHEDULE OF NURSING OFFICERS – A REVIEW

A survey was conducted among 345 nursing officers working in hospitals of Army, Navy and Air Force to find out their preferences on type of shift system, working hours in each shift, duration of night duties, entitlement of compensatory ''off days’ and distribution of ''off days’. Majority of them has demanded a change from the existing pattern of duty system, split shift to a ''modified shift’ system. The ''modified shift’ will have 6 hours each in first and second shifts and 12 hours in the third shift (night). Their preference for night duties is for a duration of two weeks with two compensatory ''off days’ at the end of the night duties in one instalment. But they opt for the compensatory ''off days’ of day shifts in instalments of one per week.KEYWORDS: Nurses’ work schedule, Shift system     

The psychiatric M��nchausen

Two cases of patients with the Münchausen syndrome who sought admission for fictitious psychiatric illnesses are presented - one case involves an accomplice. The patients'' authentic life histories are used in the discussion of the syndrome''s aetiological factors.     

Beh?et's syndrome in Scotland.

We present the clinical details and HLA typing of 15 Celtic Caucasian patients (four male, 11 female) with Behçet''s syndrome (International Study Group criteria). The males affected were younger than the affected females, and three of these males had severe uveal involvement. Two of the 15 patients had the A2 Bw6 Dr4 haplotype but this did not confer family penetrance. Eight had gastrointestinal involvement: two females required ileostomy, two females had chronic diarrhoea, one female had severe ileitis and oesophageal lesions, two males had peptic ulcers, and one female had a peptic ulcer and primary biliary cirrhosis. All of those who developed gastrointestinal symptoms had either the Dr4 or the Dr7 antigens. This study is the largest HLA survey of Celtic Caucasians with Behçet''s syndrome. The clinical features and HLA haplotypes are markedly different from ''Arab'' and ''Japanese'' varieties of Behçet''s syndrome. The expression of the Dr4 and Dr7 antigens in those with gastrointestinal involvement possibly implicates class II antigens (Dr) in the pathogenesis of the manifestations of Behçet''s disease in the bowel.     

A clinical report of entangled neonates' umbilical cord with queen's fur in Persian cat

A 3-year-old Persian queen was referred to Teaching Veterinary Hospital while 3 neonates'' umbilical cords were entangled with the queen''s tail hair. Close inspection of the cat showed that the umbilical cords of 3 kittens had twisted around together and entangled with the moms'' hairs in the base of tail region. Also this complex has been warped around the left tarsus of one of the involved kittens and caused swelling and skin darkness in the involved limb. Operation was carried out urgently. After cutting the queen''s involved hairs the kittens were released. Then the twisted umbilical cords and the hairs were isolated from the umbilical cord and the involved leg was released from the umbilical cords and the twisted umbilical cords were separated from each other. During one week follow up, dry gangrene occurred in the distal extremity of the injured limb and consequently, amputation was performed on the distal part of tibia. Our clinical findings suggest that long hair coats of queens could be a maternal life threatening factor for neonates'' life.     

感染期先天性耳前瘘管显微手术疗效

目的 探讨感染期先天性耳前瘘管显微手术疗效.方法 回顾分析合肥市第三人民医院2015年1月至2017年1月进行感染期先天性耳前瘘管显微手术的10例患者的临床资料、手术方法,分析手术疗效.结果 10例感染期先天性耳前瘘管显微手术顺利,无并发症发生,9例随访半年以上无复发,1例随访1个月以上无复发.结论 感染期先天性耳前瘘管显微手术安全有效,减轻了患者痛苦,同时缩短了治疗时间,节约了治疗经费.     

Echocardiographic diagnosis and evaluation of cardiomyopathies: idiopathic hypertrophic subaortic stenosis, Chagas' heart disease and endomyocardial fibrosis.

Echocardiographic investigations on patients with hypertrophic cardiomyopathy with obstruction have been detailed and compared with the changes found in sixty patients with chronic Chagas'' ''cardiomyopathy''. These changes are similar to those encountered in congestive cardiomyopathy. Endomyocardial fibrosis is rare in Venezuela, but six patients have been found in that country and the echocardiographic changes in one of these patients has been included in this study.     

正确认识“细辛不过钱”

[目的]讨论"细辛不过钱"之说的起源及其合理性,指导临床安全、有效运用细辛。[方法]通过对古代本草学文献的查阅,对细辛中毒临床症状的分析,对细辛的药理研究和临床实际用药效果的观察,提出对"细辛不过钱"的合理认识。[结果]"细辛不过钱"原意为细辛单用为末的情况下宜小于一钱(3.125 g),旨在避免出现中毒危及生命。而在复方煎剂中细辛不仅可以过钱,必要时还可剂量偏大或超大剂量。[结论]通过选择合理的煎煮时间和恰当的配伍,可实现细辛增效减毒,临床使用细辛组方汤剂时,可根据患者具体情况,超量使用细辛。     

Bilateral submandibular gland lymphoma in Sj?gren's syndrome.

Salivary gland lymphoma is associated with Sjögren''s syndrome. A case of bilateral submandibular gland and sublingual gland lymphoma, arising in Sjögren''s syndrome, is presented. A lymphoma involving more than one salivary gland may occur in Sjögren''s syndrome, and there is an increased risk of developing an extrasalivary lymphoma.     

'Pseudo-Alzheimer's' and primary brain tumour.

Primary brain tumour may present in the elderly purely as a dementing illness before the onset or detection of sensorimotor neurological symptoms or signs. Although neurological examination may indicate no definite signs, close attention to accepted DSM-IIIR and NINCDS-ADRDA diagnostic criteria for primary degenerative dementia and ''probable'' Alzheimer''s disease respectively will suggest a process other than a degenerative one. This was the case in two patients with primary brain tumour presenting clinically with dementing illness similar to but distinct from Alzheimer''s disease.     

A family with Alport's syndrome

Alport''s syndrome has been diagnosed in members of four successive generations of one family.     

Good prognosis in thyroid cancer found incidentally at surgery for thyrotoxicosis

An analysis of the outcome of thyroid carcinoma incidentally discovered in patients undergoing surgery for hyperthyroidism is presented. Among 986 patients with differentiated thyroid cancer, 23 had presented with symptoms and signs of hyperthyroidism. Graves'' disease was diagnosed in 11, multinodular goitre in eight and toxic adenoma in four. Following thyroidectomy, histology revealed papillary (18), follicular (four) and Hurthle cell (one) carcinoma. Tumour size ranged from 4 mm to 5.5 cm, multifocality was detected in three patients, and lymph node involvement in one. Two patients (one with associated Graves'' disease, one with multinodular goitre) relapsed locally and required further surgery; one developed distant metastases and died 7 years after initial presentation. Two patients died of unrelated causes; the remaining 20 patients are alive and well with a median follow-up of 16 (1-34) years. Differentiated thyroid cancer found incidentally at surgery for hyperthyroidism has a good prognosis.


     

URETHRAL DIVERTICULUM COMPLICATING NEISSERIAN INFECTJON A CASE RF.PORT

T T. Y., a Chinese merchant, 50 years of age was admitted to the United Hospital, Cheng''t,u on May 10, 1945 complaining of dysuria f.or 10 years and multiple discha.rging urinary sinur,.es over the scrotum and root of penis foi eight months. He had repeated ve.nereal exposures 10 yeiars ago and contracted gonor- the.a and penile sore. ''One year later urinaltion ''oelcame, increas;ingly difficult until the recent years when urine could only 70e, voided drop by drop on straining. He also foun.d that several masses developed at the perineum along the urethra which were later found to communicate with t.he urethra b.e.cause urine could be expelled from the nwatus upon piressing them. Ei.ght months ago, after taking some crude drugs, external g''eniit''alia became swollen and two dischargin.g sinus.es formed over the pre puce from which whitish fluid arained out; these healed up in 4 months'' time spon- taneously. Later on t{vo other sinuses developed, one over the bot.tom of scrotum, and the other at the dorsum of. penis :jus.t opposite the first one. All the urine carr.e through these two sinuses. for 3 t0 4 months, and only occasionally were a few drops voided from the urethral meatus. The swelling of the external genitalia decreased remarkably recently after a course of stilfadiazine. Patient also noticed marked loss of appetite and body weight for the past one year. Bowel movements normal but patient often felt tenesmus and a hot sensation in the rectum especially cluring defecation.     

RESEARCHES CONCERNING TYPHUS IN NORTH CHINA

Typtuis7 fever is endemic throughout tlae whole of North China, and every year blaims many victims. Itisimpossible to detenwine the numher of-deaths anmially from this disease; hut from the fe&r of tbt d14ease jn the:minds the common people. and from the frequency withvrhich one mwts cases of it''we know''tbat the disease-is vaery prevalentin these regions.     

阿尔茨海默病性痴呆与其他常见老年性痴呆的精神行为症状比较

老年性痴呆是老年期疾病中常见病,大部分的老年性痴呆患者有明显的痴呆行为和心理症状,伴有精神症状时往往给痴呆类型的诊断增加困难或误诊。阿尔茨海默病性痴呆为老年性痴呆中最常见的类型,故本文就近几年阿尔茨海默病性痴呆与其他类型的老年性痴呆所伴发痴呆行为和心理症状进行比较,希望对临床诊断起到一定的参考作用。     

拔戳揉捻法改善肱骨外上髁炎VAS疼痛评分的临床观察

[目的]观察拔戳揉捻法改善肱骨外上髁炎患者肘部疼痛的临床效果。[方法]选取门诊肱骨外上髁炎患者70例,随机分为治疗组和对照组。治疗组采用拔戳揉捻法治疗,对照组采用外用扶他林加护肘治疗,连续治疗2周,隔日1次,比较两组治疗前后视觉模拟评分法(VAS)疼痛评分改善情况。[结果]治疗后两组在肘部疼痛VAS评分和伸肌腱牵拉试验(Mills试验)疼痛VAS评分方面较治疗前差异均有统计学意义(P0.01),且治疗组优于对照组(P0.01);治疗组疼痛改善率优于对照组,差异有统计学意义(P0.05)。1个月随访时,治疗组整体改善率接近于优。[结论]两种方法均能改善肱骨外上髁炎患者疼痛程度,拔戳揉捻手法缓解疼痛作用优于外用扶他林加护肘治疗;拔戳揉捻手法在缓解肱骨外上髁炎患者肘部疼痛方面安全、有效、稳定。