新型隐球菌脑膜炎1例

1 临床资料 患者男性,51岁,因"反复发热、乏力伴消瘦半年,行为异常2 d"入院.患者于半年前在当地医院行痔疮手术后出现发热,体温37.5～38.0 ℃,予抗生素抗感染治疗后体温可恢复正常,但发热反复发作,伴乏力、纳差、极度消瘦,无其他不适主诉.     

伴有精神障碍的桥本脑病一例

患者,男性,39岁,主因"间断双下肢浮肿1年余,精神、行为异常伴间断发热3月"于2011年10月3日入院.患者于2010年1月起运动后出现双下肢浮肿,未重视,未特殊诊治,可自行好转.于2011年6月17日患者又出现双下肢浮肿,持续性,不能消退.就诊于内蒙古医学院附属医院,诊断"肾病综合征,甲状腺功能减退",给予对症治疗.在住院治疗过程中患者逐渐出现反应迟钝,伴有谵语,胡言乱语,应答时不符合逻辑,并出现幻觉,看见别人看不见的东西.无头痛,无恶心及呕吐等症状,当时无发热,无皮疹,无蚊虫叮咬史.1周后出现间断发热,午后低热,体温波动在37.6～38.4℃之间.精神行为异常逐渐加重,出现打人,骂人等异常行为.     

立体定向手术治疗难治性癫痫性精神障碍1例

1 临床资料 患者,男,22岁,未婚.主因"躁狂、心情烦躁、行为异常、被害妄想5 a,癫痫手术后半年"入院.患者无明显诱因于癫痫发病5 a后出现烦、易怒、伤人毁物,行为异常、幻觉、被害妄想症状,发展期逐渐出现思维逻辑错乱、脱离现实;情感、思维、意志行为与周围环境不协调,发作期间一般无痉挛发作.     

以顽固性低钠血症为首发表现的原发性肺癌1例

患者,男,49岁,已婚,农民.因纳差、精神行为异常20 d于2005年10月22日入院.家人诉发病前服用过"止痛药"后不久出现右上腹痛,行胃镜检查示十二指肠球部溃疡.院外治疗无好转,并出现纳差,渐出现少言懒语,行为异常,时有睡在地上,不理家人.无发热、盗汗,无恶心、呕吐、腹泻.否认有过咳血痰史.入院查体示:T36.5℃,P84次/min,R20次/min,BP14.7/8 kPa.中度贫血外貌.检查不合作.皮肤黏膜无黄染.全身浅表淋巴结未触及.无杵状指(趾).     

多发性硬化误诊为脑梗死1例

患者,女,已婚,46岁,因反应迟钝,言语减少1个月于2008年8月28日入院.患者于1个月前无明显诱因被家人发现其反应迟钝,言语减少,近期记忆差,有行为异常,无四肢抽搐及大小便失禁,被家人送至当地医院,诊断为脑梗死,经治疗,患者精神状态较前好转,言语较前增多,但有虚构,到我院求治,以"脑梗死恢复期"收入我科作进一步诊治.     

以发热、败血症为首发表现的十二指肠乳头癌一例

1临床资料 患者男,75岁.因"反复畏寒,发热半个月"入院.患者3年前有"胆囊切除术"史.半个月前,患者无明显诱因出现发热,伴畏寒,体温一般于午后在感畏寒后上升,波动于38℃左右,夜间可自行降至正常,一日或数日后又再次出现畏寒、发热,性质如前,发热间期体温正常,偶感胸闷、乏力,无寒战,无咳嗽咳痰,无恶心呕吐,无头昏头痛,无皮肤眼结膜发黄,无皮疹出现,无肉眼血尿,无白陶土样大便,无双下肢水肿.在当地医院予"消炎药"等治疗后无好转而来我院就诊.     

纵隔异位甲状旁腺腺瘤1例报告

患者,男,23岁.因不明原因消瘦、乏力半年,右股骨干骨折二天于1998年6月15日入院.患者体重近半年下降约30余斤,并有乏力、食欲不振,近2天无外伤情况下右股骨干骨折,骨科处理后转我科.有"肾结石"、"胆囊结石"病史.     

结肠癌术后急性肠梗阻二次手术1例报告

<正>1病例资料患者,凌某某,男性,59岁,务农。因"腹痛、消瘦半年"于2016年6月23日入院。患者入院前半年来反复出现右侧隐痛,伴有乏力,偶有低热、黏液样便,并逐渐消瘦,无恶心、呕吐、呕血等不适; 2016年6月10日在本院门诊行纤维结肠镜提示:升结肠肝区占位考虑;病理报告:升结肠中分化腺     

第242例雷诺现象—皮肤变硬—头痛

病历摘要 患者女,42岁,因双手遇冷变白2年,皮肤变硬1年,头痛1个半月于2010年5月31日入北京协和医院.患者2年前出现双手指端遇冷变白变紫变红伴疼痛,保暖可缓解,冬季症状加重.伴双膝、肘关节疼痛,无肿胀、晨僵,伴轻度反酸、烧心、纳差,偶有进食后呕吐胃内容物,无吞咽困难.1年前开始出现面部及手背、前臂皮肤紧绷变硬,并逐渐出现乏力、消瘦,症状持续加重.2个月前恶心、呕吐加重,外院胃镜检查示"浅表性胃炎、溃疡、糜烂(具体不详)".     

第242例雷诺现象—皮肤变硬—头痛

病历摘要 患者女,42岁,因双手遇冷变白2年,皮肤变硬1年,头痛1个半月于2010年5月31日入北京协和医院.患者2年前出现双手指端遇冷变白变紫变红伴疼痛,保暖可缓解,冬季症状加重.伴双膝、肘关节疼痛,无肿胀、晨僵,伴轻度反酸、烧心、纳差,偶有进食后呕吐胃内容物,无吞咽困难.1年前开始出现面部及手背、前臂皮肤紧绷变硬,并逐渐出现乏力、消瘦,症状持续加重.2个月前恶心、呕吐加重,外院胃镜检查示"浅表性胃炎、溃疡、糜烂(具体不详)".     

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…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.