Pulmonary Alveolar Microlithiasis

We report a 51 year old woman with pulmonary alveolar microlithiasis in whom the diagnosis was made by transbronchial lung biopsy and magnification radiography. Computerised axial tomography of the thorax revealed dense interstitial infiltration and diffuse pleural calcification.     

英国药学教育制度对我国药学教育发展的启示

目的:探讨英国药学教育制度对我国药学教育发展的启示。方法:分析英国药学教育制度的成功之处及其缺点,提出对我国药学教育未来发展的建议。结果与结论:英国药学教育以培训药学硕士为主,其教学内容需遵从英国药物政务局的全国统一指示性药学教学大纲,教学及考试方式以案例教学法和临床能力测验为主,有效地规范了全国的药学教育,使课程的质量和学生能力达到较高水平。这些制度对我国药学教育有正面的参考价值,也有实施的可能性。     

中国澳门地区维持性血液透析患者液体摄入依从性现状及影响因素分析

目的 描述中国澳门地区维持性血液透析患者液体摄入依从性的现状,并探讨其影响因素。 方法 采用便利抽样法,选取2020年2月1日—4月30日在中国澳门地区某医院血液透析中心进行维持性血液透析治疗的230例患者作为研究对象。采用社会人口学资料和临床情况调查表、液体摄入依从性量表、慢性病管理自我效能量表和社会支持评定量表等进行问卷调查。采用SPSS 22.0对数据进行统计学分析。 结果 230例患者中,平均透析间期体重增加相对值>5%的患者占26.1%。液体摄入依从性量表得分为（14.24±5.49）分,处于中等水平。自我效能和社会支持得分均属中等水平,相关分析结果显示,患者的自我效能及社会支持水平越高,其透析间期体重控制越好（P<0.05）。多因素Logistic回归分析结果提示,患者的自我效能总分、年龄是血液透析患者透析间期体重控制的影响因素。 结论 中国澳门地区维持性血液透析患者的透析间期液体管理效果较好,患者液体摄入依从性为中等水平,自我效能、年龄较低的患者需重点关注。护理人员应针对患者及家属制订个性化的液体管理计划,以提高患者的自我效能,增强其社会支持,进一步改善其液体管理。     

Usefulness of stable microbubble test of tracheal aspirate for the diagnosis of neonatal respiratory distress syndrome

Objectives: To compare the overall accuracy of the stable microbubble test (SM test) with measurement of level of surfactant protein A (SP-A) of tracheal aspirate for the diagnosis of respiratory distress syndrome (RDS).
Methodology: Tracheal aspirates were obtained from neonates on ventilatory support. The SM test was carried out on specimens of tracheal aspirate immediately after collection. Levels of SP-A in tracheal aspirates were determined by enzyme-linked immunosorbent assay (ELISA) method. The results of the SM test and SP-A level of the tracheal aspirates were compared against the clinical diagnosis of RDS based on clinical, radiological and bacteriological findings.
Results: Both the median microbubble counts (6 microbubbles/mm,² range = 0–90) and median SP-A levels (100μg/L, range = 0–67 447) of infants with RDS were significantly lower than those of infants with no obvious lung pathology ( P <0.0001), and pneumonia ( P <0.0001). The SM test of tracheal aspirates had higher overall accuracy for the diagnosis of RDS than measurement of SP-A levels (94.6% vs 82.4%). When the receiver operating characteristic (ROC) curves of both tests for RDS were compared, the area under the ROC curve of the SM test was larger (0.9689) than that of the SP-A method (0.8965).
Conclusions: This study showed that the SM test of tracheal aspirate was a useful bedside diagnostic test for RDS. It could be carried out at any time after birth on infants requiring ventilatory support.     

Cutaneous photosensitivity in dermatomyositis

The incidence and nature of cutaneous photosensitivity were studied in 10 patients suffering from dermatomyositis. Five reported an abnormality, which consisted of photoaggravation of preexisting cutaneous lesions in three, and abnormal transient erythemal responses in two. Monochromatic irradiation testing of all 10 patients demonstrated reduced minimal erythemal doses in two, at 307.5nm, and at 340 and 360nm, respectively; only the latter individual had clinical light sensitivity. Exposure to low-dose, solar-simulated radiation of the unaffected skin of the former patient, and five others who agreed to the procedure, three of whom complained of light sensitivity, induced a lesion with the clinical and immunofluorescence characteristics of dermatomyositis in only the first one. Four other patients replied to a mailed questionnaire, and three of these reported aggravation of their rash and provocation of new lesions by sunlight. Photosensitivity may thus be an important cutaneous feature of dermatomyositis.     

A comparative study of calcipotriol ointment and tar in chronic plaque psoriasis

The antipsoriatic efficacy, tolerability and safety of calcipotriol ointment was compared with tar in a prospective, right/left randomized, investigator-blinded controlled study. Calcipotriol ointment 50 μg/g twice daily was applied to one-half of the body. On the opposite side, white soft paraffin was applied in the morning, and coal tar solution BP 15% v/w in aqueous cream in the evening. Thirty patients with stable chronic plaque-type psoriasis were recruited. Assessments were made at 2,4 and 6 weeks. Three patients were withdrawn from the study. A decrease in PASI score was seen on both sides at 2, 4 and 6 weeks. The differences from baseline between the two treatments were statistically significant in favour of calcipotriol. Improvement with calcipotriol was rapid in the first 2 weeks of treatment. With tar, significant improvement occurred only after 4 weeks of treatment. The differences in the scores for erythema, induration and desquamation from baseline between the two treatments were also statistically significantly in favour of calcipotriol at all evaluation points. Seven patients developed irritation on the calcipotriol-treated side, but there were no adverse effects on the tar-treated side. In two patients, itching associated with psoriasis was reduced by the calcipotriol. Although the mean serum calcium and phosphate levels remained within the normal ranges after 6 weeks' treatment, there were significant changes in their values compared with baseline.     

Mechanisms of Abnormal Glucose Metabolism During the Treatment of Acute Severe Asthma

Twenty-five patients with acute severe asthma were treated withoxygen, corticosteroids and either salbutamol or aminophyllineby intravenous infusion. Blood glucose, plasma insulin and glucagonwere measured during the first 24 hours of treatment. Salbutamoland aminophylline rapidly caused hyperglycaemia, accompaniedby a rise in insulin and a fall in plasma glucagon. At firstthe increase in plasma insulin was insufficient to restore normoglycaemia,but by 24 hours homeostasis was restored. The early submaximalinsulin response was attributed to the fasting caused by breathlessness.There was no evidence of an increase in hormone secretion causedby direct ß₂-adrenergic stimulation of the pancreaticislets. The effect of corticosteroids on blood glucose overthe period of study was considerably less than the contributionof either salbutamol, or aminophylline.