柠檬色明串珠菌致尿毒症患者肺部感染一例

患者,男,22 岁,汉族,因"尿检异常10 余年,恶心、呕吐1周"于2019年11月6日入院.患者10 年前因发热、尿检异常诊断为慢性肾小球肾炎,自诉经中药治疗后"痊愈",后未规律随诊.1周前出现恶心、呕吐,伴夜间不能平卧,偶有咳嗽,无咳痰及发热,就诊于我院门诊,以"尿毒症"收入院.入院后患者间断咳嗽、无痰,体温37....     

流行性出血热致三度房室传导阻滞1例

<正>1临床资料患者女性,24岁,因"间断发热5天,恶心呕吐3天,少尿2天,晕厥1次"于2013年7月20日入院。既往体健,无手术、外伤史,无结核、肝炎等传染病史,无家族遗传病史,月经规律,育有1女孩。患者入院前5天无明显诱因出现发热,体温最高38.0℃,伴乏力、食欲差,当地诊所给予静脉滴注"阿莫西林、阿奇霉素"治疗,效果差。入院前3天出现恶心、呕吐,2天前出现少尿,尿量300 ml/日,     

酷似恶性胸腔积液的炎性胸腔积液一例

1病例简介 1.1现病史患者男性,76岁,汉族,已婚,工人,主因胸痛半月于2011-02-17日入院。缘于入院前半个月,患者出现右侧胸部疼痛,以咳嗽、深呼吸及活动后为著,伴右侧背部疼痛,伴咳嗽、咳白色黏痰,伴进食差及消瘦,无发热,无咯血,无恶心、呕吐,遂就诊于当地县级医院,     

阵发性腹痛、恶心、呕吐一天,症状好转后第三天猝死

1病例报告 男,29岁.因腹胀1 d,伴恶心、呕吐,于1998-12-21入院.患者1 d前开始出现腹胀、腹痛,以剑突下及脐周明显,呈间歇性,伴有恶心、呕吐、腹泻等,在当地医院就诊,以肠梗阻给予胃肠减压及输液治疗,半天后症状无好转,于1998-12-20下午到本院急诊科就诊并留观,于次日凌晨01:00急诊收入普外科.     

以突发性耳聋为首发症状的系统性红斑狼疮一例

以突发性耳聋为首发症状的系统性红斑狼疮一例于明忠赵君晖胡金华张彤患者女，２６岁。因右耳听力下降伴耳鸣２个月，发热、皮疹及关节痛１周入院。患者于入院前２个月，无明显诱因突然出现右耳听力下降伴持续高音调耳鸣，无眩晕、恶心及呕吐。当时到我院耳鼻喉科就诊，纯...     

脑室旁多形性黄色星形细胞瘤一例

患者男，29岁。因发作性头痛1年，加重伴恶心、呕吐1个月于2006年4月11日人院。入院前1年无明显诱因出现发作性左枕部头胀痛，无恶心、呕吐，自服“止痛药”后疼痛缓解，但头痛仍反复发作。入院前1个月头痛明显加重，伴恶心及呕吐。呕吐物为胃内容物及胆汁．2006年3月27日就诊于外院行头颅MRI检查示“左枕叶区肿块性占位灶，     

基底动脉梭形动脉瘤导致的脑干梗死二例报告

病例1，男，54岁，突然眩晕，言语不清6h，加重伴意识障碍5h，于2002年12月8日12：30就诊于河北医科大学第三医院，6h前患者小便时突发眩晕，恶心，伴言语障碍且吐字不清，口服“降压0号”，症状无好转，并出现意识障碍，呕吐，以“脑干硬死”被收入院。     

暴发性Ⅰ型糖尿病一例

患者,女性,28岁。因“多尿、多饮、消瘦3天,加重伴恶心、呕吐1天”入院。3天前,患者无明显诱因下出现多尿、多饮、消瘦,无多食,未予重视。1天前,病情加重,出现恶心、呕吐,伴中上腹阵发痛。来院就诊,查血糖28．5mmol／L,尿酮（＋＋＋＋）。为进一步诊治,以“糖尿病并酮症”收住入院。起病前1周,患者有上呼吸道感染病史,未就诊,自服百服宁等治疗后好转。既往体健。否认有糖尿病家族史。     

蛛网膜下腔出血合并心肾综合征1例

正1病例患者女性,70岁,主因"间断头晕1年,胸闷、发憋3月,加重1 d",于2018-3-20入院。患者1年前间断出现头晕,无头痛、恶心、呕吐,无胸闷、气短、发憋等,测血压240/100 mmHg(1 mmHg=0.133 kPa),间断口服"硝苯地平"治疗,未规律监测血压及进一步诊治。3月前患者出现间断胸闷、发憋、不能平卧,伴双下肢浮肿,未予重视及诊治。5 d前患者突发头痛、恶心、呕吐就诊于当地     

慢性乙型肝炎合并妊娠期肝内胆汁淤积症1例

患者,女,21岁,山西籍人。患者于2006年10月3日因妊娠8月,目黄、尿黄、皮肤瘙痒1周就诊我院。患者1周前无明显诱因出现腹泻,经治疗好转后出现目黄、尿黄、皮肤瘙痒,无恶心、呕吐、发热,未予治疗,门诊以“病毒性肝炎（乙型）慢性（中度）”收住入院。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.