The Relationship Between Psychogenic Cough and the Diagnosis and Misdiagnosis of Asthma: A Review

The differential diagnoses of persistent nonproductive cough include numerous pulmonary and nonpulmonary organic disorders as well as functional illnesses. Many diseases can cause cough, and several studies have shown asthma among the most common etiologies associated with chronic cough in adult nonsmokers, as well as children. Psychogenic cough and its relationship to asthma and other asthma-like illnesses is complex since distinct maladies with similar features may coexist individually or in combination in any given patient. While chronic cough may occur as a sole presenting manifestation of bronchial asthma in all age groups, recent findings suggest that most children with persistent cough without other respiratory symptoms do not have asthma. Since several organic, as well as functional diseases, may present with persistent cough as their sole manifestation in either adults or children, cough should not be used as a single or major determinant to diagnose and treat asthma, especially when empirically focused therapy trials fail. Given the range of illnesses causing cough, no single management guideline can be expected to be universally effective.     

应激性溃疡时幽门区局部一氧化氮含量变化对胆汁返流的影响及机理探讨

目的探讨胆汁返流与幽门区局部神经递质一氧化氮的变化对应激性溃疡发病的影响及可能的机理。方法采用冷束缚应激方法复制应激性溃疡的动物模型，将60只成年SD大鼠分为两部分，第1部分：对照组10只，溃疡组30只，用于观测影响应激性溃疡发生的相关因素；第2部分：左旋硝基精氨酸甲酯（L—NAME）预处理组10只（L—NAME组），生理盐水预处理组10只（生理盐水组），用于观测幽门区局部一氧化氮含量变化对其他因素的影响。分别检测各组胃内胆汁酸浓度、胃黏膜溃疡指数（Guth评分）以及胃内pH值，用生化试剂盒检测幽门区一氧化氮的含量。结果溃疡组应激结束后1h幽门区一氧化氮含量达到峰值（P〈0．01），应激结束后2h胃内胆汁酸浓度和pH值均达到峰值（P〈0．01），应激结束后4h胃内溃疡指数达到峰值（P〈0．01）。L-NAME组的胃内胆汁酸浓度、溃疡指数及一氧化氮含量较生理盐水组显著降低（P〈0．01，P〈0．05），而胃内pH值的差异无统计学意义（P〉0．05）。幽门区一氧化氮含量与胆汁酸浓度呈正相关（r=0．715，F=12．55，P=0．017）。结论幽门区一氧化氮含量变化与胆汁的返流量之间存在正相关关系，而L—NAME的幽门区局部干预使幽门区一氧化氮含量减少，幽门松弛程度降低，胆汁返流量也随之减少，进而降低溃疡指数，起到保护胃黏膜的作用。     

芪丹煎剂有效成分提取方法优选研究

目的:研究芪丹煎剂有效成分超声法提取的最适条件.方法:利用正交试验设计,对水量、提取时间和提取次数进行分析,找出最适条件.按最适条件重复3次,考察重复性.结果:水量为14倍、提取时间为30min,提取次数为3次时有效成分的总含量最大,3次平行试验有效成分总含量RSD为0.86%.结论:超声法提取的最佳条件为:水量14倍、提取时间30min,提取次数3次.本方法重复性较好.     

Indirect radionuclide cystography: a sensitive technique for the detection of vesico-ureteral reflux

The detection or exclusion of vesico-ureteral reflux (VUR) has classically been by micturating cystourethrography (MCUG). Radionuclide cystography will detect VUR but fails to provide the same detailed anatomical informations as MCUG. This study allowed a comparison of indirect radionuclide cystography (IRC) and MCUG in 65 children. Renal reflux was detected by IRC in 32% of renal units, while VUR was seen in 36% by MCUG. When a comparison was made with MCUG, IRC had a sensitivity of 74.1% and a specificity of 90.5%. The markedly reduced radiation dose, avoidance of a bladder catheter plus the ability to monitor the urinary tract constantly during the entire procedure should ensure that IRC is the examination of choice in follow-up studies for VUR in all toilet-trained children.     

人工晶体植入术中晶体后囊破裂的原因分析及处理

分析白内障摘除并后房型人工晶体植入术中发生晶体后囊破裂的原因和讨论处理方法。分析５５例（５５眼）白内障摘除并后房型人工晶体植入术中发生晶体后囊破裂的原因，裂口形态，大小及部位。根据具体情况采用不同处理方法。该术中合并症好发于抽吸晶体皮质及植入人工晶体时，各２１例（３８．２％），后囊破裂大小约３ｍｍ的３９例（７０．９％），５ｍｍ的１３例（２３．６％）。大于６ｍｍ的３例（５．５％）。后囊破裂的部位及形     

苯DNA加合物研究进展(综述)

苯ＤＮＡ加合物研究进展（综述）李桂兰，常平综述徐伯洪审校（中国预防医学科学院劳动卫生与职业病研究所，北京１０００５０）我国职业接触苯的工人约有５０万，长期接触苯可引起白血病。苯与其它实质性肿瘤的问题也有报道［１，２］。世界癌症研究机构（ＩＡＲＣ）１９...     

Variation in the diagnosis of vesicoureteric reflux using micturating cystourethrography

  Variability in the interpretation of micturating cystourethrography by paediatric radiologists for the diagnosis of vesicoureteric reflux in children was evaluated. All 265 micturating cystourethrograms (MCUs) that were available from 304 consecutive children aged 0.5 – 61 months  –  who were investigated after their first urine infection between 1993 and 1995 as part of a prospective cohort study  –  were selected for interpretation. Three experienced paediatric radiologists from the same department independently interpreted the MCUs according to the grading system of the International Reflux Study in Children, from grades 0 to V, with the presence of intrarenal reflux also noted. Apart from being informed that urine infection was the indication for the MCU, no other clinical information was given to the radiologists. The indices of variability used were the percentage of agreement and the kappa statistic, expressed as a percentage. Both measures were weighted with integers representing the number of categories from perfect agreement. Disagreement was analysed for children and kidneys. For the diagnosis of vesicoureteric reflux in individual patients, including grade, the percentage of agreement was 96% – 97% (kappa 90% – 91%) and the weighted percentage of agreement was 96% – 98% (weighted kappa 93% – 94%). The same high level of agreement was present for individual kidneys, with a percentage of agreement of 97% – 98% (kappa 89% – 92%) and a weighted percentage of agreement of 98% – 99% (kappa 94% – 95%). There was near perfect agreement in the interpretation of radiological micturating cystourethrography among three experienced paediatric radiologists for the diagnosis and grade of vesicoureteric reflux. Any variations in the medical care of children suspected of having vesicoureteric reflux are not explained by differences in the reporting of this diagnostic test. Received June 19, 1996; received in revised form November 1, 1996; accepted December 6, 1996     

胆汁反流性胃炎的胃运动功能研究

目的:探讨胃排空改变以及胃窦平滑肌电节律紊乱在胆汁反流性胃炎发病中的可能机制。方法:对59例有慢性上消化道症状的慢性胃炎病人,根据胃镜下可见显著胆汁反流,胃液呈深黄色或深绿色,胃液pH≥3.0,甘胆酸浓度>58μg/ml,胃粘膜病理积分>9,判断为病理性胆汁反流(部分病人经:显象进一步证实)。胃镜下未见胆汁反流,胃液清亮,其余指标均未达上述标准者判断为非胆汁反流性。选出18例胆汁反流性胃炎病人(BRG组)和17例非胆汁反流性胃炎病人(NRG组),上述检查正常的10名健康志愿者(HC组)作为对照受检者进食一份双核素标记的标准餐,用照相机以1帧/2分钟连续动态照相120分钟,部分受试者又在空腹时检测胃窦肌电。结果:BRG组有明显的固、液体双相排空延迟,以固相延滞期(SLP)延长较为突出,而固体半排空时间(HSET)延长在很大程度上受到SLP延长的影响:NRG组仅有HSET显著延长。进一步胃电检测结果表明,各组间平均慢渡频率(MSWF)无显著性差异,出现胃电节律失常(DRM)在各组的分布为HC组1/7、NRG组3/10和BRG组7/13,严重程度BRG>NRG>HC。结论:胆汁反流性胃炎者有较严重的胃窦功能不良,且胃肌电可予进一步证实,胃底和十二指肠动力异常也可能与胆汁反流性胃炎的发病有关。     

提高H2O2/甲酸体系选择性氧化抽提脱硫效率的研究

为了降低焦化蜡油(CGO)-甲酸／H2O2选择性氧化体系中H2O2的无效分解速度，屏蔽重金属离子对H2O2分解的催化效应，考察了造纸行业中常用的硅酸钠、硅酸镁和乙二胺四乙酸(EDTA)等稳定剂和螯合剂的加入对有机溶剂抽提后CGO中含硫量的影响。实验结果表明，EDTA可以很好地和重金属离子螯合，氧化后CGO抽余油中硫含量大幅降低。     

胆汁返流性胃炎胃粘膜超微结构研究

为探讨胆汁返流性胃炎的发病机理和应用中药治疗此病的效果，作者进行了胃粘膜超微结构观察。在治疗前、后取胃粘膜做光、电镜检查，发现本病胃粘膜变化突出的特点是淋巴细胞侵入腺细胞内，溶解腺细胞，破坏细胞间联接装置，使腺腔破溃，腺管萎缩。以上变化可占全部病例的８７．５％。另一特点是腺细胞内出现微囊（８例中有４例），这在慢性胃炎尚未见有电镜观察报道。作者认为胆汁返流性胃炎可以是慢性萎缩性胃炎的前驱，而腺体萎缩的原因是由于淋巴细胞的浸润破坏；这为由细胞介导引起的胃腺细胞损伤提供了形态学依据。