Intellectual performance of chronic schizophrenic patients

Intellectual characteristics of 116 male chronic schizophrenic patients were investigated by using the Quick's test of intelligence. Indirectly, by this test the thinking of examinees was analysed. The examinees were divided into age-groups and differentially diagnostic groups. According to age, they were divided into three groups: from 25 to 40, from 41 to 50, and from 51 to 60 years. There were four differentially diagnostic groups: paranoid, catatonic, and hebephrenic patients and patients with schizophrenia simplex. The study has shown that the intelligence of chronic schizophrenic patients, divided into age groups, was significantly different. The average IQ of patients from 25 to 40 years was 82.9, from 41 to 50 years 67.4, and from 51 to 60 years 52.0. The intelligence of examinees divided into differentially-diagnostic groups was also significantly different. The average IQ of paranoid patients was 74.3, of catatonic patients 64.8, of hebephrenic patients 59.2, and of those with schizophrenia simplex 57.4. Most cases with IQ = 0 related to the group with schizophrenia simplex. The willing-instinctive personality sphere and perceptual disturbances in chronic schizophrenic patients appear to exert a significant influence on their intellectual characteristics.     

Prognosis of patients receiving intensive care for lifethreatening medical complications of haematological malignancy

The mortality of patients admitted to intensive care units with haematological malignancy is high. A humane approach to the management of the critically ill as well as efficient use of limited resources requires careful selection of those patients who are most likely to benefit from intensive care. To delineate more accurately the factors influencing outcome in these patients the records of 60 consecutive admissions to the intensive care unit (37 male, 23 female) with haematological malignancy were reviewed retrospectively. Fifty patients were in acute respiratory failure, most commonly (34 patients) with a combination of pneumonia and septicaemic shock. The severity of the acute illness was assessed by the APACHE II (acute physiology and chronic health evaluation II) score and number of organ systems affected. Thirteen patients survived to leave hospital. The mortality of patients with haematological malignancy was consistently higher than predicted from a large validation study of APACHE II in a mixed population of critically ill patients. Moreover, no patient with an APACHE II score of greater than 26 survived. Mortality among the 22 patients with relapsed malignancy (21 deaths), was significantly higher than among the 35 patients at first presentation (26 deaths). On discharge from the intensive care unit all survivors had responded well to chemotherapy and had normal or raised peripheral white cell counts. They included seven patients who had recovered from leucopenia (white cell count <0.5 × 10⁹/1). In contrast, 36 of the 47 patients who died were leucopenic at the time of death.The overall mortality of critically ill patients with haematological malignancy is higher than equivalently ill patients without cancer. The dysfunction of an increasing number of organ systems, an APACHE II score of greater than 30, failure of the malignancy to respond to chemotherapy, and persistent leucopenia all point to a poor outcome.     

循证护理对肝硬化腹水患者的疗效分析

目的:循证护理根据有价值的、可信的科学研究结果,提出问题,寻找实证,对病人采用最佳的护理模式进行护理。本文通过临床观察,旨在探讨循证护理对肝硬化腹水患者的临床疗效。方法:回顾性分析我院2009年2月到2012年6月收治的74例肝硬化腹水患者的临床资料,根据不同的护理方法将所选患者分为干预组和对照组,每组各37例。对照组患者给予常规护理,干预组患者在常规护理的基础上给予循证护理。观察两组患者的心理功能、生活能力、社交功能的改善情况,并比较两组患者的并发症发生情况及治疗的总有效率。结果:在接受不同的护理干预后,干预组患者的心理功能、生活能力、社交功能均显著优于对照组患者,差异具有统计学意义(P0.05);干预组患者的并发症发生率为5.40%,显著低于对照组患者的并发症并发率16.22%,差异显著有统计学意义(P0.01);干预组患者的总有效率为94.59%,明显高于对照组患者的总有效率83.78%,两组比较差异显著(P0.05)。结论:循证护理模式有助于肝硬化腹水患者的心理功能、生活能力、社交功能得到改善,临床效果满意,值得推广。     

肝源性糖尿病45例临床分析

目的探讨肝源性糖尿病的临床特点及治疗。方法观察45例肝硬化合并肝源性糖尿病患者的临床表现,检测治疗前、治疗后的血糖情况并进行比较分析。结果肝源性糖尿病患者以肝病表现为主,血糖波动较大,以餐后2h血糖升高为主;而Child-pugh分级C级患者的血糖明显高于A、B级患者,有并发症的患者血糖明显高于无并发症的患者。结论肝硬化患者易发生糖代谢紊乱,血糖水平与肝功能情况密切相关,经早期积极治疗,血糖基本可降至理想范围并稳定。     

Cytometry of breast carcinoma: significance of plo?dy balance and proliferation index

Image cytometry of DNA distribution in fine needle biopsies of breast carcinomas at first diagnosis was performed to see if there were significant differences in DNA histograms between patients having very different outcome but same tumor histological typing and similar therapy. Two groups of patients were considered retrospectively: the first (20 patients) with survival time shorter than 5 years and the second (20 patients) with survival time longer than 10 years. Seven benign tumors were used as controls. Ten plo?dy classes were defined. The frequencies of cells in those classes were used as independent features in a supervised multivariate analysis. The advantages of this approach was pointed out with respect to the four-type classification of Auer. The scattering of DNA histograms within the feature space showed that a subgroup of patients with poor prognosis was clearly separated from a subgroup of patients with good prognosis but both long survival patients and short survival patients were scattered in between. In order to replace the multivariate classification of histograms by a simpler approach, two parameters were computed which explained most of the scattering in the feature space: the plo?dy balance (difference between the percentages of euploid and aneuplo?d cells) and the proliferation index (percentage of cells between peaks). The scattergram of patients according to these parameters showed again that some DNA distributions were specific for either good or bad prognosis. But the separation was uncertain for seven short-survival patients and six long-survival patients. For six patients, the DNA distributions were very similar between long and short survival times. Those patients thus could not be separated even by means of discriminant analysis. The main conclusion of this study was that, for a significant number of patients, the objective multivariate classification of tumors DNA profiles is of little assistance to the pathologist who has to give a prognosis for the one patient under consideration.     

Results of splenectomy in patients with hypoplastic and aplastic anemia]

The results of spleen exstirpation in 129 patients with hypoplastic and aplastic anaemia are presented. For this purpose the role of splenectomy in connection with blood formation is dealt with on the basis of analysing morphological blood findings. The impact of the duration of the disease, of sex, age, and the dosage of corticosteroids on the postoperative development of the disease is demonstrated. The following observations of the patients which were made within 3 to 14 years after the operation revealed that 63 patients from 129 survived, namely 21 patients up to 5 years, 26 patients up to 10 years, 16 patients up to 14 years. 66 patients died, the highest lethality being observed during the first year after the operation (47 patients).     

气垫床在预防压疮中的效果评价

目的：探讨气垫床在预防压疮中的应用,为减少住院患者压疮的发生提供科学依据,提高患者生存质量。方法：选择我院2011年6月-2012年6月住院患者116例为研究对象,对患者进行褥疮风险评估后将116例患者随机分为两组,一组患者使用气垫床,另一组患者普通褥疮预防和护理,对两组患者发生褥疮的情况进行比较。结果：普通组患者发生压疮26例,对照组患者发生压疮5例,经卡方比较,对照组好于普通组,P〈0.05。结论：气垫床的使用不仅可以很好的杜绝压疮的发生,还可以提高患者的生存质量。     

Tumor markers in leukemia: evaluation of serum levels of different forms of sialic acid, Regan isoenzyme and lactate dehydrogenase.

A sensitive and specific serum marker can greatly help in the early diagnosis of malignancy as well as in monitoring the treatment of cancer patients. The present work was initiated for determining serum levels of Total Sialic Acid (TSA), Lipid Bound Sialic Acid (LSA), Free Sialic Acid (FSA). Regan Isoenzyme (RI) and Lactate Dehydrogenase (LDH), so as to evaluate their value as potential tumor markers. Fifty patients with anemia and 78 patients with leukemia were studied. The leukemia group consisted of 32 cases of Acute Myeloid Leukemia (AML), 29 cases of Chronic Myeloid Leukemia (CML) and 17 cases of Acute Lymphatic Leukemia (ALL). The levels were compared with the values obtained from 88 healthy individuals. Compared to the healthy controls, all the biomarkers were significantly elevated in patients with anemia as well as in those with leukemia. However, in leukemia patients significantly higher levels of TSA, LSA, FSA and LDH were observed compared to anemia patients. TSA levels were significantly higher in AML patients compared to CML and ALL patients. LSA levels were also significantly higher in AML patients compared to ALL patients. LSA was the most sensitive (84.6%) while FSA and RI levels were the most specific (78.0%) markers for leukemia. The combined use of the markers showed increased sensitivity and specificity (100.0% and 98.0%, respectively). The study suggested that the biomarkers investigated might be used for differentiating anemic from leukemic conditions, however, more in-depth studies are indicated to assess their utility in classifying various leukemias.     

Epidemiological analysis of oral surgery procedures

The epidemiological study was conducted to assess oral health of patients referred to the Department of Oral Surgery at Clinical Hospital Center in Rijeka. The distribution of particular diagnoses and surgical interventions in relation to frequency of occurrence was tested. The total of 1,268 patients aged from 5 to 89 years, both sexes, were included in the study. All the patients were treated under local anesthesia. The most common reason for referral to oral surgery was chronic periapical lesion (33.3%), followed by retained root (26.7%), impacted tooth (12.7%), and radicular cyst (8.3%). The majority of patients, residents of Rijeka city area, were treated for the diagnosis of adult periodontitis, while the radicular cysts and hypertrophy of the upper frenulum were more frequent referral diagnoses in patients coming from the areas around Rijeka. Extractions were performed more frequently in patients from Rijeka, while cystectomies with apicectomies and frenulectomies in other patients.     

长期住院精神障碍患者现况调查

目的:探讨长期住院精神障碍患者的现况及其影响因素。方法:采用自制调查问卷对2013年1月1日至7月1日我院慢性病科住院治疗2年以上的473例精神障碍患者进行调查分析。结果:长期住院患者中,男性比例高于女性,以精神分裂症患者居多,婚姻状况以未婚者居多;合并躯体疾病315例(66.60%),合并1种疾病者145例(30.66%),合并2种以上疾病者170例(35.94%),年龄与合并躯体疾病有关,70岁以上发生率最高;因精神病性症状反复发作滞留医院131例(27.70%),因家属无法对患者进行日常照顾、家属无法管理患者,担心危害、家庭经济困难、无接收对象而仍然滞留在医院342例(72.30%)。结论:精神障碍患者滞留医院除了因为病情慢性化,也有家庭、社会、经济等因素。发展社区精神卫生防治康复工作既能降低医疗成本,也有助于改善康复期患者的生活质量。     

Perception of ecological factors in asthmatic and coronary patients

The aim of the study was to determine whether an examined group of asthmatic patients differ significantly from a control group of coronary patients with regard to perception of two groups of etiological factors and their interaction: a) ecological factors, and b) habits and behavior of the patients. The study included 100 patients with bronchial asthma and 102 with coronary disease. A questionnaire was used to obtain data on ecological factors in the living environment of the patients and information on habits and behavior. The questionnaire was structured according to the specific needs of the study, and as a starting point known, calibrated, psychometric scales were used. Asthmatic and coronary patients did not differ with regard to their place of residence, i.e. the same number lived in the town and village, in similar ecological environments, and they also did not differ with regard to life style and habits. The study indicated statistically significant differences between asthmatic and coronary patients in their perception of several ecological and other risk factors. The asthmatic patients significantly more frequently perceived harmful ecological factors in their environment and regarded them significant for the occurrence of their disease. The coronary patients perceived their unhealthy habits and behavior as the causal factors of their disease.     

The diagnostic challenge of tumors manifested initially by the shedding of cells into cerebrospinal fluid

Patients in whom the first indication of a neoplasm is the shedding of its cells into cerebrospinal fluid (CSF) present a challenging problem in differential diagnosis. The purposes of this study were to review the frequency and differential cytopathologic diagnosis of this event and to compare the distribution of neoplasms in these presentations with the overall distribution of CSF malignancy. From 1971 to 1980, 12,026 CSF specimens were examined at Duke University Medical Center, and malignant cells were seen in 318 specimens from 232 patients. No follow-up was available for seven patients, and review of hospital records disclosed five cases of false-positive diagnoses. In 25 of the remaining 220 patients, cytologic examination of CSF provided the first documentation of a neoplasm. The distribution of the 25 initial CSF presentations was as follows: 2 of 108 leukemia/lymphoma patients, 8 of 44 lung carcinoma patients, 1 of 12 melanoma patients, 0 of 18 breast carcinoma patients, 0 of 14 patients with miscellaneous primaries, 2 of 3 patients with adenocarcinoma of the stomach, 5 of 7 patients with unknown primary tumors and 7 of 14 patients with primary brain tumors.     

Level of IgE at different stages of HIV infection

The content of total IgE in 109 patients at different stages of HIV infection are presented. The infection was at the asymptomatic stage in 30 patients, the stage of generalized lymphadenopathy in 29 patients, the stage of secondary manifestations in 36 patients, the stage of AIDS in 14 patients. The concentration of IgE was found to increase, on the average, at all stages of HIV infection (p < 0.001), the maximum level being observed at the stage of AIDS. The occurrence of high and low concentrations of total IgE was the same at the asymptomatic stage and the stage of generalized lymphadenopathy. At the stage of secondary manifestations the occurrence of low concentrations of IgE increased twofold. In the presence of parasitosis a significant rise in the content of total IgE was registered in HIV-infected patients.     

Functional evaluation of the adenohypophysis with metoclopramide in hyperprolactinemic-amenorrheic women in relation to radiological findings on the sella turcica

The responses of the adenohypophyseal hormones to metoclopramide (MCP) were evaluated in hyperprolactinemic women with various radiological findings on the sella turcica. Serum PRL concentrations significantly increased after MCP administration in normal women, hyperprolactinemic patients with normal sella and patients with microadenoma, but not in macroadenoma patients with and without suprasellar expansion (SSE). The PRL response to MCP administration was significantly lower in hyperprolactinemic patients than in normal women. Serum TSH concentrations significantly increased after MCP administration in each group of subjects. The TSH response to MCP was significantly higher in patients with normal sella and patients with microadenoma than in normal women. However, the responses of PRL and TSH to MCP were not significantly different between patients with normal sella and patients with microadenoma. Therefore, they were not considered useful in distinguishing tumorous from nontumorous hyperprolactinemia. Serum LH concentrations significantly increased after MCP administration in patients with normal sella, patients with microadenoma and macroadenoma patients without SSE, but not in normal women or macroadenoma patients with SSE. The LH response to MCP was significantly higher in patients with microadenoma than in patients with normal sella. Serum FSH concentrations significantly increased after MCP administration only in patients with microadenoma. The different responses of the adenohypophyseal hormones to MCP in hyperprolactinemic women with various radiological findings on the sella turcica may be explained by the difference in the hypothalamic dopamine activity and in the impairment of the hypothalamic-pituitary system due to pituitary tumor.     

Radical surgical treatment of the urinary bladder cancer in patients over the age of 60--our experiences

The goal of the paper was the analysis of patients over the age of 60 suffering from the urinary bladder cancer that underwent radical surgical treatment of the urinary bladder and establishing urine derivation. In the 1972-2008 period 2405 patients with the urinary bladder cancer were treated, 296 (12.3%) of whom underwent radical surgical treatment. The average age was between 60 and 80 years--in 207 (70%) patients. In our patients there were 190 patients (91.6%) with transitional cell cancers. According to TNM classification, T3 stage in 92 (44.4%) patients and T2 stage in 85 (41%) patients were predominant in our study. According to histological criteria, the most common stage was G3 stage--in 151 (73%) patients. Radical cystectomy or combined with urethrectomy was performed in 178 (86%) patients. Unfortunately, in 12% of them (T3 and T4 stages) the inner iliac blood vessels were tied off due to a progressive cancer. The outer supravesical urine derivation (Bricker, U-tubing nephrostomy, and ureterocutaneostomy) was done in 163 (78.7%) patients. The inner derivation (Coffey, ureteroileosigmoidostomy, Mainz-Pouch II) was performed in 17 (8.2%) patients and neovesica (Hautmann, Studer) in 24 (11.5%)patients. There were 74 (35.7%) patients with early postoperative complications. Among them the most dominant were the surgical complications--in 28 (13.5%) patients and distant organ complications--in 22 (10.6%) patients. In 75 (36%)patients with negative nodes the survival rate was 55% after five years. In 73 (35%) patients with positive nodes the survival rate was 27% after five years.     

Cellular aspects of pathogenesis of hypertrophic cardiomyopathy: Role of cardiomyocyte polyploidy and activation of nuclear antigen of the proliferating cell in myocardium

For a comparative analysis of cytomorphological characteristics of hypertrophied interventricular septum (IVS), both patients different ages with severe courses of obstructive hypertrophic cardiomyopathy (OHCMP) were examined, including children, and patients with essential arterial hypertension (EAH). The course of OHCMP in children as compared with adults was found to be characterized by considerable IVS hypertrophy that was accompanied by an acceleration of cardiomyocyte polyploidization. The mean ploidy level of cardiomyocytes in children with OHCMP was higher than in adult patients. The mean ploidy level of nuclei, the number of prolipherative cell nuclear antigen (PCNA)-positive nuclei, and the number of polyploid cardiomyocyte nuclei in adult patients with OHCMP were significantly higher statistically than in patients with EAH. The PCNA-positive labels in stromal cells were revealed only in patients with OHCMP. The obtained data indicate an important role of cardiomyocyte polyploidy and of activation of the proliferating cell nuclear antigen in development of myocardial hypertrophy in patients with OHCMP.     

Physiotherapy of cervical migraine in the light of personal experience

The study aimed at developing optimal technique of the physical treatment of headache in the course of cervical migraine. The study involved 65 patients with headache accompanying degenerative lesions to the cervical spine. The patients were divided into two groups. Routine balneokinesitherapy was employed in one group of 25 patients whereas diadynamic current of specially adjusted parameters were additionally used in the second group of 40 patients. Markedly better results were achieved in this group as headache was nearly completely relieved in 77.5% and significantly reduced in 22.5% of the patients. In the first group of patients headache disappeared in 12% of the treated patients, was reduced in 52%, and did not change in 36% of the treated patients. Multifactorial etiopathogenesis of cervical migraine advocates the use of complex therapeutical means. Discussed therapy involving balneokinesitherapy and diadynamic currents makes a complex of factors acting on various pathogenetic elements of the disease, leading to favourable effects. Employed techniques are simple, available and free of adverse reactions.     

慢性肝病患者会员制管理方法的探讨

探索慢性肝病患者的管理方式,通过肝病患者的管理提高患者治疗的依从性,从而提高患者的治疗效果,改善患者生活质量,降低肝病患者死亡率,为患者提供更完善的医疗管理服务,为慢性疾病的管理提供新的思路。

     

Effectiveness of the antibacterial therapy of patients with various forms of dysentery]

The analysis of the efficacy of various methods of antibacterial therapy in 1382 patients with obliterated, light and moderately severe forms of dysentery as compared to the patients subjected only to patholgenic therapy showed that broad spectrum antibiotics lost their role in treatment of such patients. Furazolidon proved to be one of the most active drugs. The authors suppose that treatment of patients with obliterated forms of dysentery with antibacterial drugs is not obligatory and is indicated only in cases with repeated isolation of the causative agent.     

心脏磁共振在不明原因脑卒中病因筛查中的应用

目的探讨心脏磁共振成像技术在不明原因缺血性脑卒中患者病因筛查中的应用价值。方法选取2014年9月~2015年2月在我院诊治的不明原因缺血性脑卒中患者53例为研究对象,均行心脏MRI和经胸超声心动图检查,并对检查出卵圆孔未闭(PFO)的患者进行分析。结果 53例不明原因缺血性脑卒中患者中,心脏MRI检查诊断合并PFO为27例(50.94%),经胸超声动图(TTE)检查诊断合并PFO为7例(13.21%),差异有统计学意义(P0.001)。结论心脏MRI对PFO的检出率较高,可作为不明原因缺血性脑卒中患者病因筛查的有效手段。