华支睾吸虫病伴胆囊癌及十二指肠类癌一例

患者,男,70岁.因进行性加重的腹胀3月余,合并黄疽半月入院,患者3个月前无明显诱因出现腹胀,开始上腹胀,餐后明显,伴嗳气,无腹痛、反酸,无恶心、呕吐,未行诊治,症状逐渐加重,波及全腹,同时伴乏力、纳差、消瘦,自觉腹部日见膨大,无发热,腹泻无明显浮肿,不尿,曾于外院查B超提示腹水,胆囊癌伴肝转移,进一步查螺旋CT支持B超诊断,给予对症治疗,具体用药不详,无效,于入院前半个月,病人出现皮肤巩膜黄染,尿色加深如浓茶,但无陶土便,收住我院消化科.     

阴茎多根金属异物存留一例报告

1 病例介绍 患者,男,63岁,农民,已婚离异27年.因阴茎不规则肿大20年,排尿困难伴尿道流血2d于2006年4月17日入院. 入院时查体:体温38℃,心肺正常,膀胱区稍膨胀,压痛,耻骨联合上水肿,暗红,阴茎不规则肿大,呈马铃薯样改变,大小约12cm×10cm×8cm,暗红色,质地中等,包皮呈苍白色,与海绵体粘连成硬结,表面有多处不规则突起,多个部位有分泌物溢出,尿道口呈十字形改变,龟头苍白,阴囊略水肿,睾丸正常.     

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.     

Submission Guide

Journal of Integrative Medicine(JIM)is an international,peer-reviewed,Pub Med-indexed journal,publishing papers on all aspects of integrative medicine,such as acupuncture and traditional Chinese medicine,Ayurvedic medicine,herbal medicine,homeopathy,nutrition,chiropractic,mind-body medicine,Taichi,Qigong,meditation,and any other modalities     

贝科能致药物热1例

患者,女,49岁.因中上腹胀,厌油6d,尿黄2d,于2006年11月29日入院.患者6d前无明显诱因出现中上腹胀,与进食无关,略感厌油,无腹痛、腹泻,无纳差,无恶心、呕吐,无反酸、嗳气,无畏寒、发热.2d前,患者出现尿色变黄,并发现皮肤、眼睛发黄,嗳气,无皮肤瘙痒及皮疹,无胸痛、腹痛、畏寒、发热,无鼻NB024和牙龈出血,无关节红肿及疼痛,大便色黄.     

解读《神农本草经》

原文:夫大病之主有中风,伤寒,寒热,温疟,中恶,霍乱,大腹水肿,肠游,下痢,大小便不通,贲豚,上气,咳逆,呕吐,黄疸,消渴,留饮,癖食,坚积,症瘕,惊邪,癫痫,鬼疰,喉痹,齿痛,耳聋,目盲,金疮,踒折,痈肿,恶疮,痔,漏,瘿瘤,男子五劳七伤,虚乏羸瘦,女子带下,崩中,血闭,阴蚀。虫蛇蛊毒所伤。此大略宗兆,其间变动枝叶,各宜依端绪以取之。     

"肠覃"初探

1历史沿革与释义之争 "肠覃"二字最早见于<内经·灵枢·水胀第五十七>:"肠覃何如?岐伯日:寒气客于肠外,与卫气相搏,气不得荣,因有所系,癖而内著,恶气乃起,息肉内生,其始生也,大如鸡卵,稍以益大,至其成如怀子之状,久者离岁,按之则坚,推之则移,月事以时下,此其候也.石瘕何如?岐伯日:石瘕生于胞中,寒气客于子门,子门闭塞,气不得通,恶血当泻不泻,衃以留止,日以益大,状如怀子,月事不以时下,皆生于女子,可导而下."     

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     

经方新用治验1例

患者,男,50岁,煤矿职工。因发热、气喘、咳嗽2天,在村卫生所治疗未果,而前来卫生院就诊。患者面色苍白,发热恶寒,无汗,头不痛而重,微微气急,咳嗽响亮,咳痰,量少色白,口渴喜热饮。     

黄芪注射液静脉点滴过敏反应1例

患者,女,44岁,头晕、头痛、乏力,因长期植物神经功能紊乱,体质虚弱,并伴有失眠、多梦等症状,而住院治疗.治疗采取舒肝理气,养心安神,补气升阳的方法.给予5%葡萄糖液体250ml中加入20ml黄芪注射液,静脉点滴,大约10min后,病人突然出现胸闷、气短、心悸、畏寒,体温达39.8℃,随后出现意识不清、皮肤荨麻疹、面部肿胀,心率达120次/min.立即停止用药,给予10 mg地塞米松滴壶滴入,20min后患者进入睡眠状态,继而大汗淋漓,醒后意识清楚,生命体征基本恢复正常.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.