扑热息痛片致药疹1例

1 基本资料 患者,男,27岁,因头痛自服一片扑热息痛(0.3 g/片),约3 h后出现局部皮肤瘙痒难耐而就诊.查体:体温37 ℃,脉搏82次/min,呼吸20次/min,血压125/80 mm Hg.口唇红斑,下唇红斑上有2 cm×3 cm范围成片簇集血疱;双手虎口周围有4 cm×4 cm红斑,左手红斑上有0.5 cm×1cm血疱1个;左脚拇趾第一节趾骨背面有2 cm×4 cm红斑,右脚根部有3 cm×4 cm红斑.     

Efficacy of Getong Tongluo Capsule(葛酮通络胶嚢)for Convalescent-Phase of Ischemic Stroke and Primary Hypertension:A Multicenter,Randomized,Double-Blind,Controlled Trial

Objective:To evaluate whether the efficacy of Getong Tongluo Capsule(葛酮通络胶囊,GTC,consisted of total flavone of Radix Puerariae)on improving patients'quality of life and lowering blood pressure are superior to the extract of Ginkgo biloba(EGB)for patients with convalescent-phase ischemic stroke and primary hypertension.Methods:This randomized,positive-drug-and placebo-controlled,double-blind trial was conducted from September 2015 to October 2017.Totally 477 eligible patients from 18 hospitals in China were randomly assigned in a 2:1:1 ratio to the following interventions,twice a day for 12 weeks:(1)GTC 250 mg plus EGB-matching placebo 40 mg(237 cases,GTC group),(2)EGB 40 mg plus GTC-matching placebo 250 mg(120 cases,EGB group)or(3)GTC-matching placebo 250 mg plus EGB-matching placebo 40 mg(120 cases,placebo group).Moreover,all patients were orally administered aspirin enteric-coated tablets 100 mg,once a day fo r 12 weeks.The primary outcome was the Barthel Index(Bl).The secondary outcomes included the control rate of blood pressure and National Institutes of Health Stroke Scale(NIHSS)scores.The incidence and severity of adverse events(AEs)were calculated and assessed.Results:The Bl relative independence rates,the clinical recovery rates of NIHSS,and the total effective rates of NIHSS in the GTC and EGB groups were significantly higher than the placebo group at 12 weeks after treatment(P<0.05),and no statistical significance was found between the GTC and EGB groups(P>0.05).The control rate of blood pressure in the GTC group was significantly higher than the EGB and placebo groups at 12,18 and 24 weeks after treatment(P<0.01).There were no statistically significant differences in the incidences of AEs,adverse drug reactions,or serious AEs among the 3 groups(P>0.05).Conclusion:GTC exhibited significant efficacy in improving patients'quality of life as well as neurological function and controlling hypertension.     

抗震救灾中的传染病防治工作原则

人类的历史教训证明,包括大地震在内的严重自然灾害,对地域生态环境和人类居住条件造成极大的破坏,对灾区人员的健康造成沉重的打击.在这种情况下,发生重大传染病流行的风险将会显著增加.汶川大地震发生后,搜寻生还者,抢救伤病员是抗震救灾第一阶段的重点.     

A Bibliometrics Analysis on Academic Influence of Chinese Journal of Integrated Traditional and Western Medicine

Objective:To illustrate the academic influence of Chinese Journal of Integrated Traditional and Western medicine,and provide suggestions for further development of the Journal.Methods:Taking the China National Knowledge Infrastructure(CNKI)database as main source and the Chinese Science Citation Database(CSCD)as reference,the researchers retrieved the related data of the Journal such as its publication quantity,citations,fund projects,authors,institutions and regions from 1981 to 2018,analyzed these data by means of bibliometrics and information visualization with EXCEL,SPSS,VISIO,MATLAB and other softwares.Results:Through the analysis of the main indicators,the relevant indicators of the Journal’s academic influence revealed the developing trend of the Journal.Cardiovascular and cerebrovascular diseases,endocrine,digestive system,pharmacological research of Chinese medicine and gynecology,as the hot topics in the discipline and academic,were clarified.Conclusions:All indicators show that the Journal is a high-quality journal reflecting the excellent achievements in the field of integrated Chinese and Western medicine in China.Through further analysis of relevant indicators,the authors put forward some specific suggestions on how to run the Journal well.     

Bloodletting Puncture at Hand Twelve Jing-Well Points Relieves Brain Edema after Severe Traumatic Brain Injury in Rats via Inhibiting MAPK Signaling Pathway

Objective:To investigate whether blood-brain barrier(BBB)served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points(HTWP)in traumatic brain injury(TBI)and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated(sham),TBI,and bloodletting puncture(bloodletting)groups(n=24 per group)using a randomized number table.The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days.The neurological function and cerebral edema were evaluated by modified neurological severity score(mNSS),cerebral water content,magnetic resonance imaging and hematoxylin and eosin staining.Cerebral blood flow was measured by laser speckles.The protein levels of aquaporin 4(AQP4),matrix metalloproteinases 9(MMP9)and mitogen-activated protein kinase pathway(MAPK)signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group,bloodletting puncture improved neurological function at 24 and 48 h,alleviated cerebral edema at 48 h,and reduced the permeability of BBB induced by TBI(all P<0.05).The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture(P<0.05 or P<0.01).In addition,the extracellular signal-regulated kinase(ERK)and p38 signaling pathways were inhibited by bloodletting puncture(P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways.Therefore,bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.     

考试制度管理与改革之我见

分析目前考试制度存在的主要问题有命题、复习题、补考制度等方面的弊端,提出考试制度的改革要在加强"三风"建设、做好试题的编审工作、建立完善的考试管理制度、严肃补考纪律等方面下工夫,让严肃的考风带动良好的学风,从而提高教学质量.     

国际心肺移植新进展——2006年第26届国际心肺移植协会年会报道

2006年4月5日至4月8日第26届国际心肺移植协会(ISHLT)年会在西班牙马德里隆重召开,来自全世界从事心肺移植的专家,包括心外科、胸外科、心内科、呼吸科、麻醉科、ICU、病理科、供体协调等从事基础及临床研究等相关科室的专家共2 000多人参加了此次盛会.     

Vogt-小柳-原田综合征误诊1例报告

1临床资料 患者,男,29岁.入院前10d双眼视力突然下降,伴轻微头痛,曾就诊于其他医院,经眼科常规检查及眼部B超检查,诊断为原发性视网膜脱离,用药不详,因治疗效果不佳,于2002年10月18日来本院就诊.入院时自诉头痛明显,全身状况不佳,视力:右眼指数/1 m,左眼指数/1 m,双眼轻度睫状充血,角膜后可见细小点状沉着物,房水闪辉阳性,瞳孔呈药物性散大,直径5.5 mm,晶体不混浊,玻璃体可见条状混浊,眼压正常.     

格林巴利综合征伴一过性高血糖性酮症酸中毒一例

1病例患者,女,49岁。10日前出现中上腹不适,伴恶心呕吐,并开始出现尿量减少,全身浮肿,四肢无力,双手不能持物,双下肢不能站立,当时无咖啡样     

婴幼儿游泳探讨

游泳是人类生活中最自然的生理活动和本能之一。不仅人类，哺乳动物也常有游泳行为，是生活中自然形成和掌握的一种本能。我们认为人和动物一样，生来就具有适应环境的能力。很多动物，无论大小都有游泳本领，不用谁来教，在水中通过多种姿势和划水方法，他们都会把鼻子露出水面，往岸上游。可是人类这种本能后来泯灭了。我们认为社会就是大海，人生就如在大海中游泳，从小让孩子在水中学会挣扎，锻炼拼搏精神，促进胎儿到婴幼儿神经及各脏器的持续发育，使生长的过程得到进一步、更高质量的发展，这对他们一生的好处都是不可估量的。     

乳腺癌术后乳房再造围手术期的护理

目的介绍乳腺癌根治术后一期乳房再造的护理体会。方法应用乳房假体对5例Ⅰ-Ⅱb期乳腺癌术后患者行即时乳房再造。结果本组术后随诊4个月-2年,无排斥反应,美容效果好,无局部疼痛及不适。乳头血运良好,无挛缩。结论本手术方法简单,损伤小,不影响术后放疗及化疗.与二期乳房再造相比减少费用。     

乳腺神经内分泌癌的研究进展

乳腺神经内分泌癌（neuroendocrine carcinoma of breast,NEBC）是一种临床上较为罕见的乳腺肿瘤,尚缺乏明确的规范化诊疗指南,该病的组织起源尚不明确,目前主要有三种观点,其中,NEBC可能是乳腺干细胞分化为神经内分泌和上皮细胞的早期结果这一观点更被接受。NEBC临床特征及病理特征稍突出,但影像学表现不具特异性,单凭影像学难以与其他类型乳腺癌鉴别。NEBC诊断方法已经较为明确,确诊依靠病理学检查中神经内分泌标志物的检测。治疗原则为以手术为主、全身治疗为辅的综合治疗,相较于其他类型乳腺癌,NEBC的疗效较差。因此,寻求特异性高的治疗方法成为当今NEBC研究的主流,多个研究着手于对NEBC基因突变的检测,力求研发出针对其高频突变位点的靶向治疗药物。同时,NEBC预后较差,确诊该病后,应积极治疗并坚持随访,及时发现疾病新的变化或进展。     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

Electrical impedance scanning in breast tumor imaging: correlation with the growth pattern of lesion

Background This study researched the electric impedance properties of breast tissue and demonstrated the differentcharacteristic of electrical impedance scanning (EIS) images.Methods The impedance character of 40 malignant tumors, 34 benign tumors and some normal breast tissue from 69patients undergoing breast surgery was examined by EIS in vivo measurement and mammography screening, with aseries of frequencies set between 100 Hz-100 kHz in the ex vivo spectroscopy measurement.Results Of the 39 patients with 40 malignant tumors, 24 showed bright spots, 11 showed dark areas in EIS and 5showed no specific image. Of the 30 patients with 34 benign tumors there were almost no specific abnormality shown inthe EIS results. Primary ex vivo spectroscopy experiments showed that the resistivity of various breast tissue take thefollowing pattern: adipose tissue＞cancerous tissue＞mammary gland and benign tumor tissue.Conclusions There are significant differences in the electrical impedance properties between cancerous tissue andhealthy tissue. The impedivity of benign tumor is lower, and is at the same level with that of the mammary glandulartissue. The distinct growth pattern of breast lesions determined the different electrical impedance characteristics in theEIS results.     

乳腺钙化的X线诊断

根据钙化的大小、形态、数目、分布结合临床及病理资料分析乳腺钙化的 X线平片 ,有助于良恶性病变的鉴别。在111例乳腺钙化中良性病变显示为 78例 ,恶性病变显示为 33例。其结论是乳腺微粒钙化不可认为是乳腺癌的特异性征象 ,也可较多见于乳腺良性病变。如在成簇的微粒钙化中出现多种形态或不规则钙化 ,则提示有恶性诊断的价值