疑似表现为慢性荨麻疹的胃癌一例

患者,男性,50岁,2005年突发全身皮肤瘙痒,以胸腹、腋窝明显,有时呈丘疹状,因瘙痒夜不能寐,食欲正常,精神状态良好。既往史：有高血压病史,否认肝炎、结核病史,否认手术、输血史。无烟酒嗜好,无食物及药物过敏史。体格检查：体温36．8℃、脉搏84次／分、呼吸18次／分、血压152／90mmHg,心肺听诊正常,神志清楚,心电图检查正常。全身皮肤：红色散在丘疹,无黄疸,胸背、四肢均可见新旧搔抓痕迹,未见瘀点、瘀斑,全身浅表淋巴结未触及肿大,腹部平软,肝脾未触及,无压痛。实验室检查;血常规、血生化检查、肝肾功能、血糖正常,血脂升高。超声检查;肝、胆、脾、胰、肾正常。诊断：慢性荨麻疹。治疗：对症处理、中药治疗历时二年余,症状一直未得到缓解,     

匠心何处

正在老辈人那里,匠,是一种标准,一门过硬的技术或谋生手艺。生活,离不了匠。瓦匠、石匠、木匠、花匠、剃头匠,铁匠、杂匠、裁缝、秤匠、修锅匠、补碗匠、弹花匠……我觉得,匠和匠人,更像一缕古风。平淡无奇的生活里,忽然来了一个手艺人,种种奇巧、古怪的细作,像一个明朗但有着硬壳的谜语,引发快意。"补—碗嗬,碗补!"声声吆     

寿与“七伴”

寿与众伴 生命之树欲常青,须扎根在肥沃的土壤中——与周围人融洽相处。与众为伴、远离孤独的人,生活充实,有安全感,充满信任、爱心和友情,十分有利于保持老年人心理和生理平衡,从而健身延寿。 寿与动伴 常言道:“动则不衰,用则不退。”老年人经常从事一些力所能及的劳动或运动,如扫地、淋浴、浇花、登楼、做操、打太极拳、户外散步、慢跑、跳交谊舞、短程旅游等,可利关节、丰肌肉、通血脉,延缓各脏器组织的衰老。 寿与艺伴 即使你身上     

不可小视的“情绪污染”

空气污染、用水污染、噪音污染、食品污染、电子污染……这些常见的污染,严重影响着我们的生活质量。然而,有一种污染,却十分容易被人们忽视,这就是＂情绪污染＂。专家认为,情绪是客观事物作用于人的感官而引起心理体验,有两个特性。一是两极性,如快乐—悲哀、热爱—憎恶、轻松—紧张、激动—平静等。二是暗示感染性。     

如何缓解心理压力

社会的发展与变革,会使人们的观点、态度、希望也随之变化,在这个快节奏、高效率、充满竞争与挑战的社会中,人们常常会受到内外环境的强烈影响,出现情绪上的波动和生理上的变化,从而产生心理压力。要想知道自己是否承受压力,不妨问问下面这几个问题: 1.经常显得不耐烦、暴躁、焦虑、易怒。 2.睡眠品质较差、失眠,经常打哈欠、发困。 3.健康指数明显下滑,经常感到不舒服,容易生病,感冒、头痛、胃痛、消化不良、溃疡、     

1100例儿童微量元素检测结果分析

目的了解费县0～6岁儿童体内微量元素含量及不同时期的变化规律。方法采用微量元素检测仪器检测1100例儿童微量元素铜、锌、钙、铁、铅含量。结果在不同年龄组间锌、钙、铁、铅含量差异显著（P值均〈0.05）,锌、铁、铅含量随年龄的增长而逐渐增加,钙含量随年龄的增长而逐渐降低。铜含量差异无显著性（P值〉0.05）。结论费县儿童存在锌、钙、铁微量元素缺乏,应注意均衡饮食,加强铁、钙、锌的补充及促进其吸收。远离铅污染,预防铅中毒。     

“头”等大事，别忽视

大脑在整个身体中扮演着最重要的角色,成年人的脑重量大约为2.7斤,由100多亿个神经元构成,它指挥着人体生理和心理各种活动。脑支配着人体的各个功能,如语言、运动、思维、情绪等等,一旦脑受到损伤,就会引发多种疾病。大脑不健康包括两个方面,一个是器官方面的,如脑卒中、脑炎等。一个是精神方面的,如头昏目眩、发呆、反应能力降低、记忆力下降、不容易集中精神等症状。     

北京地区妊娠期糖尿病对新生儿早期的影响

目的分析妊娠期糖尿病对新生儿的影响,为临床管理妊娠期糖尿病母亲婴儿提供参考。方法分析我院2007年1月至2007年12月出生的398例糖尿病母亲新生儿的临床资料,同期产科正常孕妇所生新生儿428例作为对照组,对其早期临床并发症进行比较分析。结果糖尿病母亲新生儿易发生多种临床问题:大于胎龄儿、巨大儿、早产儿、红细胞增多症、呼吸窘迫综合征、低血糖症、畸形。其发生率观察组分别为25.1%、8.8%、6.5%、5.5%、4.5%、4.0%、2.5%,对照组分别为6.8%、2.6%、2.3%、0.5%、0.2%、0.5%、1.9%。其中观察组中大于胎龄儿、巨大儿、早产儿、红细胞增多症、呼吸窘迫综合征、低血糖症发生率明显高于对照组,差异有统计学意义(P0.01)。观察组与对照组畸形发生率比较,差异无统计学意义(P0.05)。结论妊娠期糖尿病对新生儿有较大的危害,孕期应及早诊断,严格控制血糖,分娩后应对婴儿及时监测,早期发现并治疗相关合并症。     

藏缅语族6个未识别群体皮褶围度特征

目的 在四川、云南、西藏调查木雅人、尔苏人、僜人、白马人、夏尔巴人、摩梭人13项皮褶围度指标,比较这些族群皮褶围度的差异。方法 使用皮尺和皮脂厚度计进行6个未识别群体成人1222人（男性576人,女性646人）的围度和皮褶厚度测量,所得数据采用Excel 2007、SPSS 17.0统计学软件进行处理,并将这6个族群的数据与国内其他7个民族做比较。结果 随着经度的增大,男性族群肩胛下皮褶、髂前上棘皮褶值逐渐增大。女性族群髂前上棘皮褶值随着经、纬度的增高而增大。根据主成分分析,在男性族群中,木雅人、尔苏人、白马人、摩梭人的肩胛下皮褶、平静胸围和上臂最大围均较大。夏尔巴人的肩胛下皮褶和平静胸围值较小,而夏尔巴人的上臂最大围较大。僜人的肩胛下皮褶、平静胸围和上臂最大围均较小。在女性族群中,木雅人、尔苏人、白马人、摩梭人的臀围、上臂围较大,而腓肠肌皮褶、肩胛下皮褶均较小。僜人的臀围、上臂围较小,而腓肠肌皮褶、肩胛下皮褶均较大。夏尔巴人的臀围、上臂围、腓肠肌皮褶和肩胛下皮褶均较小。结论 通过聚类分析与主成分分析,木雅人与尔苏人的围度与皮褶最接近。白马人与摩梭人的皮褶围度特征接近。僜人的皮褶围度特征与佤族、独龙族最为接近。夏尔巴人与珞巴族、门巴族最为接近。     

经鼻内镜切除腺样体手术后引起皮下气肿和纵隔气肿1例

患儿,男,13岁。因睡眠打鼾3年入院。体检:心、肺正常,肝、脾未扪及,神经系统未见异常。血常规、尿常规、肝肾功能、ECG、胸部X线片均正常。专科检查:咽部黏膜光滑,双侧扁桃体I度肿     

Characterization of Hawaiian isolates of Cymbidium mosaic virus (CymMV) co-infecting Dendrobium orchid

We report here the isolation and characterization of three distinct isolates of Cymbidium mosaic virus (CymMV) co-infecting Dendrobium orchid in Hawaii. Isolates 1 and 2 were phylogenetically distinct from previously reported CymMV isolates. However, isolate 3 was highly similar to previously reported CymMV sequences and could be localised to CymMV subgroup A. Isolate 2 localised to CymMV subgroup B. Thus, we report here the first full-length CymMV subgroup B isolate. Isolate 1 represents a recombination event between isolates 2 and 3. Infectivity assays revealed that all three isolates are functional and individually infectious in both Dendrobium and indicator species.     

An amalgam of pathogenic and beneficial endophytic fungi colonizing four Dendrobium species from Meghalaya,India

Endophytic fungi are known to play an important role in driving the evolution of plants by conferring adaptational advantages to their host through the production of secondary metabolites and phytohormones. In this study, we evaluated the diversity and phylogenetic relationship of endophytic fungal communities from four Dendrobium species viz., Dendrobium chrysanthum, Dendrobium heterocarpum, Dendrobium hookerianum, and Dendrobium longicornu of Meghalaya, India. A total of 51 culturable endophytic fungi were isolated from the four selected orchid species. The isolates were identified based on nuclear large subunit sequences into 33 species. Approximately 91% of the isolates showed affinity to Ascomycetes, while 9% of the isolates showed BLAST search similarity to Basidiomycetes. The most common genera were Trichoderma and Xylaria. The most prevalent genera were Fusarium, which was detected in all the four Dendrobium species followed by Diaporthe, which was present in three Dendrobium species viz., D. chrysanthum, D. hookerianum, and D. heterocarpum. The Shannon index value of endophytic fungal communities was the highest in D. chrysanthum (2.66), while D. longicornu (1) had the highest Evenness index. The present study revealed that endophytic fungi in these orchids are an amalgam of pathogenic and beneficial fungi, which have, at the least, switched their lifestyle to asymptomatic endophyte in their host. To our knowledge, this is the first such report on the diversity of endophytic fungi in the four selected Dendrobium species from Meghalaya, India.     

五种药用石斛内生真菌抑制HIV-1整合酶活性研究

目的 评价5种药用石斛内生真菌发酵产物抑制HIV-1整合酶的活性.方法 将分离自石斛的202株内生真菌提取物共404个采用高通量ELISA法评价其抑制HIV-l整合酶活性;对抑制活性大于100％的样品进行量效关系考察并进行体外抑制肿瘤细胞活性筛选.结果 筛选得到19个对HIV-l整合酶抑制活性大于80％的样品,其中样品5119F、5297F、5097F、5140J和5211F的抑制率分别达到117.96％、113.53％、108.62％、103.74％和109.02％,其对应的IC50值分别为0.02024、0.003125、0.00862、0.01007 和 0.01192 mg/ml.结论石斛属药用植物内生真菌是一个潜在的、丰富的用于筛选HIV-1整合酶抑制剂的资源库,值得进一步研究和开发.     

金钗石斛生物碱对糖性白内障大鼠诱导型一氧化氮合酶基因的调控

目的探讨金钗石斛生物碱对半乳糖所致糖尿病性白内障大鼠晶状体中一氧化氮(NO)、诱导型一氧化氮合酶(iNOS)活性及其基因表达的影响。方法将Wistar大鼠随机分为正常对照组、模型组、样品高、低剂量组和阳性对照组,每组10只,模型组腹腔注射D-半乳糖诱导大鼠白内障模型,样品高、低剂量组和阳性对照组在注射D-半乳糖26d后形成Ⅱ级白内障后每天分别给予0.36、0.18g/kg金钗石斛总生物碱灌胃进行实验性治疗,阳性对照组每天以0.22g/kg石斛夜光丸灌胃,正常对照组每天仅灌胃生理盐水;用裂隙灯观察观察晶状体浑浊度;46d后处死动物后取晶状体,硝酸还原法测定NO的含量、比色法检测NOS的活性,提取各组晶状体RNA,应用实时荧光定量PCR技术检测iNOS基因的表达。结果金钗石斛生物碱治疗组和正常对照组、阳性对照组的NO浓度及NOS的活性均显著低于模型组,实时定量PCR表明金钗石斛生物碱可下降iNOS基因的表达。结论金钗石斛生物碱能有效抑制iNOS基因的表达,对糖尿病性白内障具有较好的治疗作用。     

铁皮石斛的组织培养研究

本文通过实验总结出组培铁皮石斛各个阶段的培养基。诱导培养基N_6 BA2.5mg/L;N_6 BA2.5mg/L IBAO.5mg/L;分化培养基N_6 BA1.5mg/L NAA1.2mg/L 5％香蕉汁;生根壮苗培养基N_6 NAA2.5mg/L 1O％土豆汁。     

Difficulties and challenges in the development of precision medicine

The rapid development of precision medicine is introducing a new era of significance in medicine. However, attaining precision medicine is an ambitious goal that is bound to encounter some challenges. Here, we have put forward some difficulties or questions that should be addressed by the progress in this field. The proposed issues include the long road to precision medicine for all types of diseases as the unknown domains of the human genome hinder the development of precision medicine. The challenges in the acquisition and analysis of large amounts of omics data, including difficulties in the establishment of a library of biological samples and large-scale data analysis, as well as the challenges of informed consent and medical ethics in precision medicine, must be overcome to attain the goals of precision medicine. To date, precision medicine programs have accomplished many preliminary achievements and will help to drive a dramatic revolution in clinical practices for the medical community. Through these advances, the diagnosis and treatment of many diseases will achieve many breakthroughs. This project is just beginning and requires a great deal of time and money. Precision medicine also requires extensive collaboration. Ultimately, these difficulties can be overcome. We should realize that precision medicine is good for patients, but there is still a long way to go.     

Catalogue of knowledge and skills for sleep medicine

Sleep medicine is evolving globally into a medical subspeciality in its own right, and in parallel, behavioural sleep medicine and sleep technology are expanding rapidly. Educational programmes are being implemented at different levels in many European countries. However, these programmes would benefit from a common, interdisciplinary curriculum. This ‘catalogue of knowledge and skills’ for sleep medicine is proposed, therefore, as a template for developing more standardized curricula across Europe. The Board and The Sleep Medicine Committee of the European Sleep Research Society (ESRS) have compiled the catalogue based on textbooks, standard of practice publications, systematic reviews and professional experience, validated subsequently by an online survey completed by 110 delegates specialized in sleep medicine from different European countries. The catalogue comprises 10 chapters covering physiology, pathology, diagnostic and treatment procedures to societal and organizational aspects of sleep medicine. Required levels of knowledge and skills are defined, as is a proposed workload of 60 points according to the European Credit Transfer System (ECTS). The catalogue is intended to be a basis for sleep medicine education, for sleep medicine courses and for sleep medicine examinations, serving not only physicians with a medical speciality degree, but also PhD and MSc health professionals such as clinical psychologists and scientists, technologists and nurses, all of whom may be involved professionally in sleep medicine. In the future, the catalogue will be revised in accordance with advances in the field of sleep medicine.     

物理学在医学影像中的应用

物理学对医学的贡献是巨大的，物理学与医学等学科的交叉碰撞在医学领域中产生了许多丰硕成果，现代的医学影像就是其中的成果之一。本文阐述了物理学在现代四大医学影像中的应用。     

Incentive for a shift from modern scientific medicine to integrative medicine

Medicine has been evaluated in recent years both quantitatively and qualitatively. Contemporary medicine has been assumed to be conceptually based on modern science. However, there is a problem that quantity and quality are hard to evaluate using only scientific parameters. It is, therefore, the aim of this article to emphasize that the quantity and quality of medicine need to be evaluated not only from the standpoint of modern scientific medicine but also in terms of integrative medicine. Integrative medicine is postulated to be comprehensive in its fundamental doctrine, emphasizing a holistic approach including technical, artistic, social, religious, philosophical, and ethical elements. However, in evaluating carefully and seriously actual performance, it was noted that contemporary medicine has been giving greater emphasis to aspects of integrative medicine where increasing concern is paid to patients' personal preferences, as indicated by their quality of life. An incentive for a shift from exclusively scientific to integrative medicine, which started as early as the 1970s, is revival emotion toward a prime modality of medicine. Part of this article was presented at the 43rd annual meeting of the Japanese Society for Artificial Organs on December 1, 2005     

Standard procedures for adults in accredited sleep medicine centres in Europe

The present paper describes standardized procedures within clinical sleep medicine. As such, it is a continuation of the previously published European guidelines for the accreditation of sleep medicine centres and European guidelines for the certification of professionals in sleep medicine, aimed at creating standards of practice in European sleep medicine. It is also part of a broader action plan of the European Sleep Research Society, including the process of accreditation of sleep medicine centres and certification of sleep medicine experts, as well as publishing the Catalogue of Knowledge and Skills for sleep medicine experts (physicians, non-medical health care providers, nurses and technologists), which will be a basis for the development of relevant educational curricula. In the current paper, the standard operational procedures sleep medicine centres regarding the diagnostic and therapeutic management of patients evaluated at sleep medicine centres, accredited according to the European Guidelines, are based primarily on prevailing evidence-based medicine principles. In addition, parts of the standard operational procedures are based on a formalized consensus procedure applied by a group of Sleep Medicine Experts from the European National Sleep Societies. The final recommendations for standard operational procedures are categorized either as 'standard practice', 'procedure that could be useful', 'procedure that is not useful' or 'procedure with insufficient information available'. Standard operational procedures described here include both subjective and objective testing, as well as recommendations for follow-up visits and for ensuring patients' safety in sleep medicine. The overall goal of the actual standard operational procedures is to further develop excellence in the practice and quality assurance of sleep medicine in Europe.