主观症状及实验检查诊断早期干眼症

目的 分析主观症状及实验检查对早期干眼症患者诊断的意义。方法 对55例（109眼）已确诊的早期干眼症患者（无或仅伴有轻微体征）的临床症状及实验检查进行回顾性分析及比较。结果 患者中主观症状所占比率：干涩感94％，视疲劳感82％，异物感74％，明显高于其他症状（P〈0．05）。实验检查的阳性率：基础泪液分泌试验（Schirmer I test，SIt）35％，泪膜破裂时间检查（break-up time，BUT）85％，角结膜荧光素（fluorescent，FL）染色60％，其中BUT阳性率明显高于SIt和FL（P〈0．05）。结论 主观症状及实验检查可为早期干眼症诊断提供有利依据。     

马来西亚寒邪致病及其证治初探

根据第一作者在马来西亚从事中医临床工作50余年的经验,以中医理论为指导,探讨了在炎热的马来西亚,寒邪致病的可能性、客观性以及寒邪致病的病因、病机、临床表现特征及其治疗方法。     

No difference in symptoms of irritable bowel syndrome between healthy subjects and patients with recurrent depression in remission

There is bidirectional comorbidity between anxiety/depression and irritable bowel syndrome (IBS). To investigate the prevalence of IBS symptoms, and factors associated with gastrointestinal symptoms in patients with recurrent depressive disorder. Patients (n = 95) with recurrent type of major depression according to DSM-IV criteria and sex- and age-matched controls (n = 190) were sent questionnaires investigating symptoms of IBS [Gastrointestinal Symptom Rating Scale (GSRS)-IBS] and symptoms of anxiety and depression [Hospital Anxiety and Depression Scale (HADS)]. Medical records were checked over a 10-year period for chronic somatic symptoms or diseases. Seventy-three patients with unipolar disorder (mean age 63.6 years SD 13.8; range 23-86 years) and 156 controls (mean age 59.2 years SD 11.6, range 21-85 years) responded. Patients with recurrent depression had higher GSRS-IBS scores and showed a strong correlation between symptoms of IBS and anxiety-depression (r(s) = 0.54; P < 0.001). IBS symptoms were also associated with multiple pain symptoms, higher health-seeking behaviour and selective-serotonin-reuptake inhibitor intake. However, patients with recurrent depression (n = 46) in remission (HADS-Depression score <8) did not have more symptoms of IBS than controls (GSRS-IBS median score 6.0 vs 6.5; P = 0.46). There is a strong association between symptoms of IBS and symptoms of anxiety and depression, whereas depressive patients in remission do not have more IBS symptoms than controls.     

Partial replication of a DRD4 association in ADHD individuals using a statistically derived quantitative trait for ADHD in a family-based association test.

BACKGROUND: Previous research found an association between single nucleotide polymorphisms (SNPs) in the promoter region of DRD4 and statistically derived phenotypes generated from attention-deficit/hyperactivity disorder (ADHD) symptoms. We sought to replicate this finding by using the same methodology in an independent sample of ADHD individuals. METHODS: Four SNPs were genotyped in and around DRD4 in 2631 individuals in 642 families. We developed a quantitative phenotype at each SNP by weighting nine inattentive and nine hyperactive-impulsive symptoms. The weights were selected to maximize the heritability at each SNP. Once a quantitative phenotype was generated at each SNP, the screening procedure implemented in PBAT was used to select and test the five SNPs/genetic model combinations with the greatest power to detect an association for DRD4. RESULTS: One of the four SNPs was associated with the quantitative phenotypes generated from the ADHD symptoms (corrected p-values = .02). A rank ordering of the correlation between each of the ADHD symptoms and the quantitative phenotype suggested that hyperactive-impulsive symptoms were more strongly correlated with the phenotype; however, including inattentive symptoms was necessary to achieve a significant result. CONCLUSIONS: This study partially replicated a previous finding by identifying an association between rs7124601 and a quantitative trait generated from ADHD symptoms. The rs7124601 is in linkage disequilibrium (LD) with the SNPs identified previously. In contrast to the previous study, this finding suggests that both hyperactive-impulsive and inattentive symptoms are important in the association.     

A follow-up study of respiratory function in workers exposed to acid aerosols in a food-processing industry

A follow-up investigation was performed on 49 female workers studied 2 years earlier in a vegetable-pickling plant. Acute and chronic respiratory symptoms and ventilatory capacity measurements were recorded during the original and the follow-up studies. Maximal expiratory flow-volume (MEFV) curves were recorded during the Monday morning work shift. The forced vital capacity (FVC), 1-s forced expiratory volume (FEV1), and flow rates at 50% and the last 25% of the FVC (FEF50, FEF25) were measured. There were small increases in the prevalence of chronic symptoms between the two studies for both smokers and nonsmokers, but these did not reach statistical significance. Five workers at the time of the initial study had a diagnosis of occupational asthma; only one of these was still working at the time of follow-up. Workers lost to the follow-up had lower lung function than those seen at follow-up. In workers who were followed, larger than expected mean annual declines were noted for all ventilatory capacity parameters in both smokers (FVC 0.070 l, FEV1 0.070 l; FEF50 0.355 l/s, FEF25 0.270 l/s) and nonsmokers (FVC 0.045 l, FEV1 0.045 l, FEF50 0.285 l/s; FEF25 0.130 l/s). The decrease was particularly pronounced for FEF50 and FEF25. The accelerated decline in ventilatory capacity tests noted in the female nonsmokers suggests an independent effect on lung function of work exposure in this environment. Our data confirm that work in the pickling industry, particularly in small, poorly regulated plants, has deleterious effects on respiratory function. Received: 24 September 1996 / Accepted: 19 June 1997     

The impact of lower urinary tract symptoms on general health status and on the use of prostatectomy

Our objective was to determine the extent to which lower urinary tract symptoms affect the general health status of men and contribute to the decision to undergo surgery. A cross-sectional population survey using postal questionnaires was conducted in the North West Thames health region, followed by a prospective cohort study of men undergoing prostatectomy (North West Thames and Oxford regions). The subjects in the first survey were 221 men aged 55 and over with previously reported mild, moderate or severe urinary symptoms; subjects in the second study were 388 men undergoing prostatectomy. Main outcome measures were selfreported symptom severity, bothersomeness and general health status (Nottingham Health Profilie, Part 1). The response rate among eligible responders in the population survey was 85.7%. Increasing symptom severity was associated with worsening NHP scores for energy, emotional reactions, sleep and physical mobility (p<0.01). Increasing bother-someness of symptoms was associated with emotional reactions, sleep and pain (p<0.05). Men undergoing surgery reported worse health status than men in the population with the same severity of symptoms as regards emotional reactions, energy and pain. For a given level of symptom severity, the impact of those symptoms on aspects of a man's general health status may be the determinant of seeking and undergoing surgery. Greater understanding of the factors that affect a man's response to his symptoms is needed in interpreting the decision to seek and accept treatment.     

Foreign body aspiration in children. The diagnostic value of signs,symptoms and pre-operative examination

One hundred and fifteen patients, between 6 months and 12 years of age, had bronchoscopy on suspicion of foreign body aspiration. The histories of these patients were studied to examine the diagnostic value of signs, symptoms and examinations, and to determine the time that passed between aspiration and removal of the foreign body. The sensitivity of the symptoms choking and coughing was fairly high (81 and 78%), but the specificity was poor. The sensitivity of a chest radiograph was 82%, the specificity 44%. The sensitivity of radiographs on inspiration and expiration was 80%, the specificity 55%. The patients had been referred with the initial diagnosis foreign body aspiration (80), pneumonia (34), or subglottic laryngitis (1). In 85 patients a foreign body was identified and extracted. The other 30 patients had respiratory tract infections. The initial diagnosis of foreign body aspiration was correct in 61 out of 85 patients. In these cases, the period between aspiration and extraction of the foreign body was a mean 6 days, compared with 55 days, if the initial diagnosis was pneumonia or sub-glottic laryngitis. We conclude that the diagnosis of foreign body aspiration is too often missed, and that, apart from bronchoscopy, diagnostic tools are of little value.     

晚期肺癌的中医证候研究

目的　探讨晚期肺癌的主要中医证候。方法　采用回顾性与前瞻性相结合的方法进行临床观察。结果　经 χ2 检验 ,不同中医证候的晚期肺癌组之间有显著性差异 (P <0 0 1) ,而血瘀证、气虚证、痰证、阴虚证最为多见 ;晚期非小细胞肺癌与晚期小细胞肺癌的中医证型没有显著性差异。结论　晚期肺癌的中医证候以血瘀证、气虚证、痰证、阴虚证为主 ;晚期非小细胞肺癌与小细胞肺癌的中医证候无明显差异。