Study of M?nchausen syndrome / 中华风湿病学杂志

Objective To explore the methods of identifying factitious/fraudulent disorders (M?n-chausen syndrome), enhancing the understanding of their predisposing factors, clinical features, and underlying psychopathology. Method After a final diagnosis of factitious fever was made, data of 4 patients presenting with a puzzling fever of unknown origin were analyzed and compared with those of other cases reported in the English literature. Result It was confirmed that the elevated temperature recorded in the clinical charts of the 4 patients was faked by manipulating of the thermometer. Conclusion These 4 cases show the existence of factitious/fraudulent disorders in China, possibly related to an abnormal psychology, but the tricks employed by the patients are relatively simple compared with those used abroad.

The decrease of CD4~+ T cells of patients with SARS in early stage and its clinical significance / 中国免疫学杂志

Objective:To observe the change of CD4 + T cells of SARS patients in early stage of disease and determine its clinical significance on the progress of disease and therapy selection.Methods:Detection the absolute counts of T cell subset from the peripheral blood samples of 52 SARS patients in initial 10 days' duration by Flow cytometry.Serial frontal chest radiographs had done and the progression of disease was observed during the treatment of all patients.Results:The 34 cases among the 52 patients were in normal range of CD4 + cell absolute count.At the same time,their pulmonary lesions were in limited degree and the states of an illness were stabilization and the pulmonary lesions were absorbed quickly.Therefore they reuired the treatment without corticosteroids.The other 18 patients were with low CD4 + cell absolute count, of which 13 cases showed progressive deterioation of radiographic change and were treated with corticosteroids additional.The other 5 cases with the mild low of absolute count of CD4 + cells were also static during the period of observation,and no treatment with coticosteroids.There was statistically significant relation between two groups(P=0 000).The results of Pearson correlate analysis between absolute count of CD4 + cells and pulmonary lesions were r=-0 737;P=0 000;The result between absolute count of CD4 + cells and corticosteroids treatment were r=-0 573;P=0 000.Conclusion:Peripheral blood CD4 + cell absolute counts of SARS patients on early stage of onset were negatively related to the degree of pulmonary lesions.The patients with remarkable decrease of CD4 + cell were in need of treatment with corticosteroids.