慢性腹痛(6)

4慢性右下腹痛4.1慢性阑尾炎慢性阑尾炎,是临床上较常见的,以右下腹痛为主的疾病。少数病人可出现上腹部不适或疼痛,易与溃疡病和慢性胆囊炎相混淆。有的还引起痉挛性便秘,类如结肠痉挛。女性病人,有时还误诊为慢性输卵管炎。4.1.1临床表现病人感右下腹持续性隐痛或不适感,或间歇性轻度疼痛。并只局限于右下腹,行走过久、过急或剧烈运动,可诱发症状加重。病人多半有急性阑尾炎病史。有的病人有反复发作急性阑尾炎情况,和伴上腹不适、消化不良等症状。腹部检查:腹平软,肝脾不大,右下腹阑尾部位局限性深压痛,位置固定,但无包块可触及。无腹肌…     

元素医学(6)

人体必需微量元素钴的生理功能及临床应用钴是人和哺乳动物必需的微量元素。早在1879年Azary就指出钴对造血有良好效能。1948年首次从生物体中分离出维生素B_(12)(氰钴胺),随后又发现了许多与维生素B_(12)有关的化合物。钴参与酶的组成和     

业务测验(6)

方法沿虚线剪下答卷,用钢笔正楷填写姓名、职称、工作单位、详细地址及用作发奖品标签上的详细地址、姓名。将正确答案填入答卷中(用其它纸无效)。于5月5日前(以邮戳为凭)自备信封,贴足邮票,寄“广州中山医学院《新医学》编辑室业务测验(6)收”。答案与奖励答案和题解第5期公布。本刊将择优评出一等奖约200名,二等奖约800名,纪念奖约1,000名,分别赠送盖有“业务测验优秀奖”章的医药书籍(一、二等奖)或风景明信片(纪念奖),一等奖名单第8期公布。     

老年生理(6)

试简述老年人锻炼健身应遵循的原则。科学适量是锻炼健身最重要的因素,老年人运动要做到科学适量,总的说来应遵守循序渐进、量力而行、坚持不懈、合理安排、动作认真、注意安全等原则。 1.老年人各器官、系统功能减弱,对运动负荷的适应能力较差。据观察,30岁以上的人1周可以适应的运动负荷,50岁时约需1.5～2周,60岁时就约需2～2.5周才能适应。因此老年人运动时的活动量应缓慢增加,逐步适应,切忌操之过急。 2.老年人健身运动要适可而止,量力而行。从主观     

病理生理学辅导(6)

黄疸黄疸是很多疾病过程中出现的一种临床表现。由于胆红素代谢障碍,血浆中胆红素浓度增高引起巩膜、皮肤、粘膜组织和体液等黄染,称为黄疸。正常血清胆红素浓度低于1mg%,如果超过2mg%时,临床上即出现黄疽。如果血清胆红素浓度虽已超过正     

病例6(问)

<正> 已决定给一名4岁半、体重15公斤,患甲型血友病(因子Ⅷ缺乏)的男孩施行心血管手术.分管他的儿科心脏学家报告说,患儿有严重的肺动脉狭窄,轻度的室间隔缺损和卵圆孔未闭.因患儿发育迟缓,右心室进行性肥大,以及心脏病的症状日趋严重,故需进行外科手术.     

急性传染性肝炎(6)

处理:在前驱症状期及黄疸加深时,需要卧床休息。因为过度劳累会延长临床病程,使症状加重。在病毒性肝炎的早期血液及大便都有传染性。因此所有的注射器及针头等都应彻底消毒。并采取消毒措施处理本病患者的排泄物。急性肝炎的饮食调理不是重要因素。对本病的中毒病例并有严重的衰竭或有出血倾向者最好输血浆或输血.     

临床护理解剖学(6)

骨髓穿刺术骨髓穿刺术是用骨髓穿刺针穿到骨松质内,抽吸红骨髓作检查用,或借穿刺输入同种异体红骨髓以达某种治疗目的。一、一般资料骨髓可分为两类:红骨髓与黄骨髓。红骨髓充满     

征询读者意见反馈(6)

贵刊办得较好，处处体现一个“新”字。栏目设置、刊登文稿等方面均表现出贵刊诚心为读者的诚意。贵刊的栏目设置较为合理，但病例报告与医生手记有重设之婊，可合并为一个栏目；国内期刊文担与国外医学简讯可合并为国内外期刊文摘栏目。建议设置中西医结合、医学英语学习栏目。要把《新医学》办好、办活，我认为应继续坚持“新”、“实用”的特色，适当介绍高、精、尖内容；进一步提高质量，形式仍需多样化；杂志的定价宜考虑广大基层读者的承受力。同时要扩大读者群，组建通讯联络网络，加强宣传，尤其是要在平时多宣传，除了在贵刊上宣传…     

医学继续教育测验卷(6)

1． 对 象：订阅《 新医学》杂志的读者可自愿报名参加，每年缴交160元学费含试卷处理费、证书费、挂号邮费等后，将正确的答案填入杂志的测验答卷上；每人一期参加测验一次（第二次答卷无效），凡第一次参加测验者请注明寄交学费的邮汇号码，接到汇款和答卷后，本刊将在计算机上开户并发给学号。第二次以后参加测验者请自填学号。2． 测验方法：阅读在《 新医学》刊登的指定文章（文章由本刊约请高级职称以上人员撰写），并按规定参与本刊的测验，测验答卷寄至广州市中山二路74号中山医科大学《新医学》编辑部继教室，本期测验答卷有效…     

中国图书分类号(6)

(上接第 6期 )Ｒ2 4 6　针灸疗法临床应用Ｒ2 4 6 .1　内科Ｒ2 4 6 .2　外科、针刺麻醉法Ｒ2 4 6 .3　妇产科Ｒ2 4 6 .4　小儿科Ｒ2 4 6 .5　肿瘤科Ｒ2 4 6 .6　神经精神病科Ｒ2 4 6 .7　皮肤病、性病科Ｒ2 4 6 .8　五官科Ｒ2 4 6 .81　耳鼻咽喉科Ｒ2 4 6 .82　眼科Ｒ2 4 6 .83　口腔科Ｒ2 4 6 .9　其他Ｒ2 4 7　其他疗法Ｒ2 4 7.1　食养、食疗Ｒ2 4 7.3　外功　专论医疗保健锻炼等入此。Ｒ2 4 7.4　导引、气功　气功疗法入此。Ｒ2 4 7.9　中医康复医学Ｒ2 4 8　中医护理学　综合性护理入此。Ｒ2 4 8.1　内科护理Ｒ2 4 8.2　外科护理　伤科…     

About 7–day (circaseptan) and circadian changes in cold pressor test (CPT)

We assess circadian (CD) and circaseptan (CS) changes in the blood pressure (BP) response to a 1–min immersion of the hand into ice water, the cold pressor test (CPT). An about 8 mmHg BP increase in the CPT reported by others for health and an elevation >25 mmHg for patients with “hypertension” have been viewed as predisease, but variables related to the vascular system exhibit prominent CD, CS and circannuals, among other components of their genetically anchored time structure or chronome, and may also have to be considered. Hence, a 16-year-old adolescent (ML) immersed her hand into ice water every 2–4 h for 2 days and once daily in the morning thereafter for 1 week (N = 25), as did, only for <2 days (≥24 h), four adults 20–66 years of age. BP and heart rate (HR) were monitored automatically around the clock at 15–min intervals and at 1–min intervals before and immediately after the CPT. Data were analyzed by cosinor. The difference between the first post-CPT BP value and the mean of the last seven values prior to the CPT was a measure of CPT response (at 1–min). Overall, ML’s systolic (S) BP increased by 8.2 ± 1.4 mmHg and her diastolic (D) BP by 6.2 ± 0.9 mmHg (P < 0.001). Increases were found in 96% of the tests for SBP, 92% for DBP and 20% for HR. There was only one tie for HR (4%), resulting in a HR decrease in 76% of CPTs. The BP response to CPT at 1 min was CS-dependent. The CS double amplitudes are 12.5 ± 4.1 for SBP (P = 0.019) and 7.8 ± 2.8 mmHg for DBP (P = 0.030), with acrophases occurring on late Sunday, early Monday (at –50° and –67° from 00:00 h from Saturday to Sunday for SBP and DBP, respectively, with 360° ≡ 1 week). The response of HR did not allow the detection of a CS rhythm (P = 0.969). The CD response peaked in the early morning hours; with 24 h ≡ 360° and 0° = local midnight, the acrophase (φ) for SBP is at –80° and for DBP at –113°, in keeping with earlier results from four adult subjects (SBP: –37°; DBP: –42°), individual differences notwithstanding. The average timing of the largest overall response of BP to CPT coincides with the timing of the response to other stimuli. The CS acrophases coincide with the times of increased morbidity/mortality from vascular diseases. Chronomes, time structures broader than circadian, notably their about-weekly components, should be considered, not only at the extremes of life when the CS and about-half-weekly rhythms are particularly prominent in BP and HR but also in interpreting BP responses as a gauge of vascular disease status in adolescents.     

继续医学教育试题(6)

继续医学教育试题(6)一、选择题1.大肠癌的血行微转移:()A.可用RT-PCR法测定细胞角蛋白20的mRNA判定;B.可用RT-PCR法测定人端粒酶催化亚单位的mRNA判定;C.以上mRNA表达水平与癌细胞分化程度无关;D.以上mRNA表达水平与肿瘤的Dukes分期无关。2.日本血吸虫抗原SjMP10是:()A.含无蚴的虫卵分泌的;B.可能引起血吸虫病患者形成肝脏虫卵肉牙肿;C.可用作ELISA法检测特异抗体的包被抗原;D.用于检测急性、慢性血吸虫病患者的IgM类特异抗体。3.抗人P53IgY抗体是:()A.用P53免疫鸡后自鸡卵黄中提取的;B.不激活补体;C.不与类风湿因子反…     

继续医学教育试题(6)

一、单项或多项选择 (答案 1～ 4个 )1 用氧化酶法在自动生化分析仪上测血清结合胆红素与重氮法测直接胆红素比有以下特点 (　 )　　A 分析全自动化　　　　　　　　　　　　　　　　B 可同时测定δ胆红素　　C 更有助于病情的动态监测D 试剂中不需加入抗坏血酸氧化酶2 用 2 ,     

营养与健康(6)

5.维生素:人体对维生素的需要量极少,它既不构成身体组织,也不产生热量,但却是维持健康、促进生长和调节生理机能不可缺少的,是身体所必需的.维生素的主要功能是参与代谢过程,影响组织的氧化还原作用,调节能量的转变。缺乏维生素可导致代谢紊乱,影响正常的生理机能,引起相应的维生素缺乏症。     

Exercising your patient: which test(s) and when?

With the introduction of the stair climb test of surgical patients in the 1950s, the role of exercise-based testing as a useful diagnostic tool and an adjunct to conventional cardiopulmonary testing was established. Since then, we have witnessed a rapid development of numerous tests, varying in their protocols and clinical applications. The relatively simple "field tests" (shuttle walks, stair climb, 6-minute walk test) require minimal equipment and technical support, and so are generally available to physicians and patients. At the other end of the spectrum is the cardiopulmonary exercise test (CPET), more complex in its equipment requirements, technical support, and with an often complex interpretive strategy. The 6-minute walk test (6MWT), in particular, has evolved into a versatile study with diagnostic utility in many disorders, including COPD, pulmonary hypertension, interstitial lung disease, congestive heart failure, and in the pre-surgical evaluation of patients, among others. With the added dimensions of optional O(2) saturation monitoring and calculated post-exercise heart rate recovery, the 6MWT is providing important clinical information well beyond the measure of distance walked. Is it sufficiently robust and informative to replace the more demanding and less available CPET? In many instances, the clinical applications are overlapping, with the 6MWT functioning as an adequate surrogate. However, in the initial evaluation of unexplained dyspnea, in formal evaluation of impairment and disability, in detailed evaluation of congestive heart failure, and in the selected lung cancer patient prior to resection, CPET remains superior. Investigations of portable metabolic and cardiovascular monitoring devices aiming to enhance the diagnostic capabilities of 6MWT may further narrow or close the remaining gap between these two exercise studies.     

心血管疾病系列问答(6)——心肌病(下)

问:原发性扩张型心肌病与冠心病如何鉴别? 答:50岁以上扩张型心肌病,当表现为房颤、心绞痛、传导阻滞、快速性室性心律失常、心肌损害、异常Q波等常被误诊为冠心病,下列诸点可资鉴别:①本病心脏增大远比冠心病显著,尤其呈左右心普大     

医学名词介绍(6) 心血管病学(上)

汉文名英文名心动周期cardiaccycle额外刺激extrastimulation程控刺激programmedelectricalstimulation ,PES程控额外刺激programmedextrastimulation偶联间期couplinginterval起搏刺激 pacingstimulation成串train阵发快速burst变速ramp超速overdrive亚速underdrive探查电极exploringelectrode希氏束电图Hisbundleelectrogram ,HBE希氏束电位分裂splitofHispotential室房传导ventriculo atrialconduction回波搏动echobeat心室重复反应repetitiveventricularresponse ,RVR递减传导decrementalconduction窦室传导sinoventricularconduct…     

test

针对无人船运动非线性、大时滞性、时变性的特点,分析了PID和模糊控制的不足。将模糊控制和PID控制结合,设计了一种模糊PID控制器,增强了PID控制的自适应能力。仿真结果表明,模糊PID控制器比传统的PID控制有更好的动态特性。