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There are diverse opinions concerning the exact position of the psychotic hysteria in the psychiatric classification. Thus, 314 cases of psychotic hysteria admitted into our hospital during the period of September 1958 to March 1967 were analyzed. The male/female ratio was 1:4.6. Half of the patients had onset of the disease when they were 26-40 years old; 64% had character traits of over-anthusiasm and/or narrowmindedness. Only 1.56% had family history of mental disorder. According to symptomatology, the patients... There are diverse opinions concerning the exact position of the psychotic hysteria in the psychiatric classification. Thus, 314 cases of psychotic hysteria admitted into our hospital during the period of September 1958 to March 1967 were analyzed. The male/female ratio was 1:4.6. Half of the patients had onset of the disease when they were 26-40 years old; 64% had character traits of over-anthusiasm and/or narrowmindedness. Only 1.56% had family history of mental disorder. According to symptomatology, the patients might be classified into: (1) Hysterical psychomotor excitment state (exaltation or maniac condition). (2) Hysterical psychomotor inhibited state (stupor or depression). (3) Hysterical confusion state (delirium, oneirism, consciousness, twilight state, fugue or duplicated personality). (4) Hysterical dementia (puerilism, pseudodementia or Ganser's syndrome). (5) Hysterical hallucinatory paranoid state (hallucination and/or delusion). The clinic manifestations were variable, complex and complicated, so it was not able to establish a certain model form. About half of the patients were accompanied with hysterical somatic symptoms and disturbance of consciousness; 15% of them showed amnesic syndrome. Their psychotic symptoms usually disappeared rapidly after treatment, yet responsed not so well to the suggestive therapy. If repeated attacks occurred in the course of disease, the rate of complete recovery tended to be lowered. As to prognosis, 37% of the patients could not be restored to their original work capacity. 140 cases were followed for 11-20 years after discharge from the hospital and no one case turned to become another psychotic disease. It is recognized, therefore, that psychotic hysteria is a special clinical type of hysteria and it should be classified as a definite psychiatric disease entity. 精神病型歇斯底里能否在精神病学分类中占有地位,历来存有争议。木文通过对314例患者分析,提示:男女之比1∶4.6,半数壮年发病,64%患者性格热情量窄,有家族史者仅1.59%,发病均有诱因。本组重点归纳的五大类临床精神症状错综复杂,无模式可立;约半数病例伴歇斯底里躯体症状及意识障碍;15%呈现遗忘症状群。精神症状治疗奏效迅速,所需药量小。但不因暗示而缓解,反复发作,彻底缓解减少,工作效能预后不太乐观。通过本文资料,我们确认该症是歇斯底里的一种特殊类型,应为一个客观存在之疾病单元。 The clinical data of 70 patients, 59 male and 11 female, 10-50 years old, who underwent renal transplantation in Shanghai in the years 1969-1979 were analyzed. According to our experience, for a successful anesthesia, the followings deserve special attention. 1. Patient should have his operation under optimal conditon. Blood dialysis was often used to restore normal blood biochemistry. 2. Initially we used acupuncture anesthesia, but on account of its incomplete analgesia and poor relaxation, we adopted continuous... The clinical data of 70 patients, 59 male and 11 female, 10-50 years old, who underwent renal transplantation in Shanghai in the years 1969-1979 were analyzed. According to our experience, for a successful anesthesia, the followings deserve special attention. 1. Patient should have his operation under optimal conditon. Blood dialysis was often used to restore normal blood biochemistry. 2. Initially we used acupuncture anesthesia, but on account of its incomplete analgesia and poor relaxation, we adopted continuous epidural anesthesia. The advantages of the latter are good relaxation, less disturbance in postoperative metabolism and renal function, as well as maintenance of consciousness safeguarding against aspiration of gastric contents. A two catheter method of continuous epidural anesthesia was found to be better, since it required less supplemental medication. 3. In poor risk cases, electrocardiogram, central venous pressure; mean arterial pressure and urine flow rate should be continuously monitored to obtain information regarding function of cardiovascular and renal systems. 4. Blood transfusion should be given sparingly to minimize antibody formation. Washed red cells may be used if necessary. 5. Other measures such as diuretics, corticosteroids and immunosuppresive agents should be used intraoperatively. 上海地区于1969~1979年间施行同种异体肾移植70例,本文就其中有关麻醉的一些问题进行了讨论。认为麻醉前应采用血液透析,以减轻尿毒症并纠正水、电解质及酸碱平衡;连续硬膜外麻醉时肌松良好,对肾功能影响少,病人清醒,不致发生胃内容物误吸;双导管连续硬膜外麻醉较单导管为佳;重危病人应连续监测心血管和肾脏功能;应尽量避免输血,必要时可输洗涤红细胞;术中还应给以利尿药、皮质激素及免疫抑制剂等。 57 cases of sporadic encephalitis (l955-1980) were reported. Most of them were children and youths. No seasonal difference was present about the onset of illness. Upper respiratory tract infections were common predisposing illnesses. Most patients ( 73.6% ) had acute or subactue onsets without fever. Headache, mental abnormalities with disturbance of consciousness and hemiplegia were the most prominent clinical manifestations. Cerebrospi-nal fluid examination revealed normal findings in 20 cases ( 35.0%).... 57 cases of sporadic encephalitis (l955-1980) were reported. Most of them were children and youths. No seasonal difference was present about the onset of illness. Upper respiratory tract infections were common predisposing illnesses. Most patients ( 73.6% ) had acute or subactue onsets without fever. Headache, mental abnormalities with disturbance of consciousness and hemiplegia were the most prominent clinical manifestations. Cerebrospi-nal fluid examination revealed normal findings in 20 cases ( 35.0%). Intra-cranial hypertension, pleocytosis and hyperalbuminosis were present in 11, 17 and 32 cases respectively. Abnormal EEC was recorded in 39 cases (86.7%),most commonly of diffuse Isowing activity. Most of them responded favorably to corticosteroid treatment. 7 patients died (12.0%). Thee most frequent cases of death were secondary infection and cerebral herniation. Patients once recovered had rather slight residual manifestation in spite of an overwhelming clinical manifestation during acute stage. Autopsy in 2 cases revealed demyelinating brain-stem encephalitis in one and Bale's sclerosis in the other. Authors suggested that acute demyelinating encephalopa-thy would probably account for at least a part of sporadic encephalitis. 散发性脑炎发病无季节性,多见于儿童及青壮年,以发热、感冒等为诱因,多以急性或亚急性起病。精神症状及意识障碍常见,可伴肢体瘫痪及颅神经受累;脑脊液检查大多正常,少数压力、蛋白及白细胞轻度增高;异常脑电图以弥散漫活动为主。皮质类固醇治疗大多奏效。住院死亡7例,多死于脑疝或继发感染。急性期病情严重者一旦恢复则很少致残,后遗症亦微。两例尸检中,一为脱髓鞘性脑干脑炎,一为同心圆性硬化。
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