嗜酸性粒细胞性胃肠炎1例

患者,女性,35岁,"因反复左下腹痛1个月加重1周"为主诉于2009年6月20日入院.否认食生鱼及动物接触史,无食物过敏及支气管哮喘史.查体:体温36.8℃,脉搏80次/min,呼吸16次/min,血压100/70 mm Hg(1 mm Hg=0.133 kPa).     

类孟买血型孕妇人工流产1例报道

患者,女,27岁,G5 P2+2,因"停经13+6周,要求终止妊娠"于2013年3月13日就诊.患者平素月经不规则,1周前拟外院行人工流产,术前发现合血困难,转至我院,经血型基因及血清学检测发现:ABO基因型:A 02/O 02;α1岩藻糖基转移酶基因(FUT1):328G/A,832G/A;血清学表型:Ah(A类孟买型).既往史:患者2004年顺产1次,2011年剖宫产1次,期间2次人工流产史,无外伤史及其他手术史.     

华法林致自发性腹膜后出血一例

<正>1病例资料患者,男性,64岁,于2013年6月13日入我院重症监护科,有"心房颤动"史,口服华法林2.5 mg每日1次,一直未规则测凝血酶原时间(PT)与国际标准化比值(INR)。有"皮肌炎"史,对多种药物过敏,否认外伤史。2013年6月7日患者出现左下腹持续性疼痛,伴左侧腰背部牵涉痛,至我院就诊。血常规:血红蛋白92 g/L;腹盆增强CT示(见图1):左侧腹膜后病变。入住我院消化科,查体:血压138/80 mmHg,腹部饱满、软,左侧中下腹部压痛明显,有轻度反跳痛,左肾区叩痛阳性。凝血系列:     

不同剂量米非司酮联合甲氨喋呤治疗异位妊娠的疗效观察

目的探讨不同剂量米非司酮联合甲氨喋呤(MTX)对未破裂型异位妊娠的疗效。方法2001年6月至2005年6月长葛市人民医院对86例未破裂型异位妊娠病例进行分析,随机分成Ⅰ、Ⅱ两组:Ⅰ组应用米非司酮25mg每日2次,连服3天;Ⅱ组应用米非司酮150mg每日1次,连服3天。两组均在第二天服药同时应用MTX75mg 生理盐水20ml静脉注射。结果Ⅰ组成功率74.42%(32/43),Ⅱ组成功率90.70%(39/43),两组间差异有显著性(P<0.01)。结论应用米非司酮450mg联合MTX75mg方案较米非司酮150mg联合MTX75mg方案保守治疗异位妊娠成功率高,且药物毒副反应没有增加。     

输卵管开窗术后同侧宫角妊娠足月分娩1例

患者33岁,G3P0(孕3产0),因"停经39 4周,阴道流液30 min"于2004年6月25日入院.平时月经规则,人工流产1次.2001年因异位妊娠行右输卵管开窗术,术后避孕半年.末次月经2003年9月21日,预产期2004年6月28日,停经32 d出现阴道少许流血,B超提示:"宫内妊娠,宫角妊娠(右)".行保胎治疗(黄体酮20 mg肌肉注射1次/d)2周.停经40 d出现轻微早孕反应,孕3个月自然消失.孕期无异常,产前检查正常.入院前30 min出现阴道流液,量约200 ml,色清亮,伴不规律下腹胀痛.入院检查:体温36.8℃,脉搏84次/min,呼吸20次/min,血压110/70 mmHg,宫高33 cm,腹围110 cm,胎方位LOA,胎心142次/min,扪及不规律宫缩,估计胎儿体质量3 400 g.肛查:先露头,高浮,宫口未开,胎膜已破,羊水清亮.B超:双顶径9.2cm,羊水指数11.7 cm,FL7.7cm,胎盘Ⅱ级,胎儿颈部见一"W"型压迹.     

三种不同方案保守治疗异位妊娠90例的临床疗效观察

目的 探求对未破裂型异位妊娠保守治疗的最佳方案.方法 将2006年6月～2009年7月收集的90例未破裂型异位妊娠病例进行分析,随机分成Ⅰ、Ⅱ、Ⅲ3组:Ⅰ组采用MTX 20mg加入输液中隔日静脉滴注5次,联合四氢叶酸(C.F)隔日肌注5次;Ⅱ组采用MTX 50mg/m2单次分臀肌注;Ⅲ组在Ⅱ组方案的基础上同时分别加用米非司酮150mg口服.结果 Ⅰ、Ⅱ、Ⅲ3组成功率分别为66.67%(20/30)、93.33%(28/42)、86.67%(26/30);Ⅰ组与Ⅱ组间及Ⅲ组间差异有显著性(p＜0.05).Ⅲ组及Ⅱ组间差异无显著性(p＞0.05).结论 使用MTX 50mg/m2单次肌注较分次静脉滴注加C.F解毒方案疗效好,而加用米非司酮方案不仅未增加疗效,同时还相应地增加了药物的毒副反应.     

长期服用阿托伐他汀钙导致严重肝功能异常1例报告

<正>1病历摘要患者,男,86岁,因畏寒、发热、咳嗽2 d于2012年6月28日入院。患者既往有高血压病史十余年,服用硝苯地平缓释片20 mg,2次/d;2011年3月因脑梗死一直口服西洛他唑片50 mg,2次/d,阿托伐他汀钙片20 mg,1次/d。曾于2011年7月检查肝功能显示:丙氨酸氨基转移酶(ALT)12.9 U/L,门冬氨酸氨基转移酶(AST)20.5 U/L;2012年3月肝功能示:ALT     

口服异搏定致Ⅱ°窦房阻滞一例

患者女,60岁。因原发性高血压病、冠心病并心律失常,于1990年5月1日第6次住院。心电图:频发房性早搏,慢性冠状动脉供血不足。查体:神志清,肥胖体型,颈静脉无怒张,双肺(一),心界不大,心率70次,律不整,可闻及早搏7～8次/分,A2>P2,心尖区可闻及ⅡSM。腹软,肝脾不大,双下肢不肿。入院后给予异搏定(常州制药厂生产)40mg,一日三次口服,早搏消失。于6月19日上午10时突感心悸、胸闷伴出汗,查心电图出现Ⅱ°窦房阻滞。此时异搏定服用总量达4620mg,西比灵服用总量75mg(6月14～6月19日),考虑为异搏定毒副反应,立即停药。给予对症处理,6月     

奥扎格雷钠治疗急性脑梗死诱发痛风3例报告

1 病例资料病例1,男,72岁,以"口角歪斜伴言语困难1d"为主诉于2010年3月5日入院.患者既往有痛风病史4年.入院后查头颅磁共振示"左侧基底节区、半卵圆区及颞叶急性脑梗死".入院后给予氯吡格雷(波立维)75 mg/d口服,奥扎格雷钠(丹奥)40 mg(2次/d)静滴,依达拉奉30 mg(2次/d)清除自由基,忌嘌呤饮食.     

超剂量应用多巴胺抢救急性心肌梗塞合并心源性休克二例

<正>病例1:患者,男,68岁,因"突发剑下不适2 h"于2009年1月19日18时入院。患者2 h前在玩麻将时,突感眼前发黑,剑突下不适,伴全身大汗,持续不缓解,无放射痛,急打"120"来我院急诊,心电图提示急性下壁心肌梗塞,静滴5%葡萄糖溶液250 ml加胰岛素4 u,加硝酸甘油10 mg,6~8滴/min,后送入循环病房。2型糖尿病史2年,现二甲双胍每次500 mg/次,3次/d,口服。吸烟史40余年。人院体检检查,体温36.9℃,脉搏80次/min,呼吸16次/min,血压90/60 mmHg,神志     

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.     

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…     

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.     

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     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.