戈谢病与帕金森病研究进展

帕金森病是一种常见的老年神经系统变性疾病,最新的研究发现,帕金森病与少见的遗传病戈谢病有关。戈谢病患者帕金森病的临床特征,多数发病年龄早,无明显的静止性震颤,对左旋多巴的反应差,也有典型的左旋多巴有反应的帕金森病。葡萄糖脑苷脂酶基因突变,即使是杂合子也有发展为帕金森病的危险,而且帕金森病患者葡萄糖脑苷脂酶基因突变比普通人群高。在戈谢病合并帕金森病患者病理研究中发现共核蛋白阳性的路易体和包涵体。     

新型冠状病毒肺炎中医名实病机辨——新型冠状病毒肺炎中医探讨之一

为明确本次新型冠状病毒引起的传染病在中医范畴的病名、病机、发病特点,规范治疗原则,本文通过临床治疗和观察,结合历代文献资料,对本病的病名、病位、病机进行了鉴别、梳理,认为本病的中医病名应当为“湿毒疫”,易陷入膜原而成重症,病机为邪气闭阻三焦,湿浊郁而成毒,病程较长,容易缠绵反复。病位多在太阴肺脾,后易累及多脏。     

158例钙化性心脏瓣膜病的临床分析

目的:探讨老年性钙化性心脏瓣膜病的临床特点及其与冠心病的关系。方法:回顾分析1998年至2004年间652例>60岁住院老年人的超声心动图及临床资料。结果:钙化性瓣膜病的发生部位以主动脉瓣最多见;经过临床诊断确诊为冠心病的有425例,以ACS为主,其次是陈旧性心肌梗死,稳定型心绞痛。钙化性心脏瓣膜病与血糖、血压、血超敏C反应蛋白(CRP)、血脂异常、冠心病高有关,钙化组的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)均明显高于非钙化组(P<0.001)。在钙化组,冠心病的患病率明显高于非钙化组(P<0.01)。结论:钙化性心脏瓣膜病与冠心病、高血压病、血脂异常、血糖、血超敏C反应蛋白关系密切,超声心动图可作为常规检查手段。CRP可以作为预测心脏钙化性瓣膜病的指标。     

获得性血友病A的治疗进展

获得性血友病A是一种由于多种原因导致机体产生凝血因子Ⅷ抗体引起的凝血缺陷性疾病, 该病发病率极低, 且病死率较高, 因该病少见, 故常误诊, 以致延误治疗, 故早期诊断及及时治疗对减少该病的死亡率至关重要.对于该病的治疗原则主要为控制急性出血、根除抑制物、治疗原发病, 故合理及个性化选择治疗方案也很关键.     

从风、痰论治肾脏病的理论与实践

肾脏病在中国的发病率逐年攀升，肾脏病的治疗是目前医学研究的热点与难点之一，而中医药对于肾脏病的治疗具有一定优势。长期以来，从风邪论治肾脏病已经达成一定共识，而对痰邪与肾脏病的关注略显不足。肾脏病的发生发展与风、痰密切相关，风邪、痰邪既是肾脏病的发病因素，又可作为病理产物影响肾脏病的预后。文章结合西医的研究进展与临床实践总结，试述从风、痰论治肾脏病的临证思路与治疗体会，以期为制定肾脏病的中医诊疗方案提供借鉴与参考。     

“治未病”理论在慢性肾脏病防治中的应用

慢性肾脏病（CKD）是临床常见多发病,也是严重危害人类健康的重要疾病。《内经》中＂治未病＂的实质包括未病先防、既病防变和病后防复。概而言之,就是预防疾病的发生和发展,防患于未然。即未病之时,固护正气,预防疾病的发生;已病之时,防止疾病传变;病情缓解之时,预防复发。分别从未病先防、既病防变、病后防复几个方面来论述《内经》中＂治未病＂理论在慢性肾脏病防治中的应用。     

单纯疱疹病毒感染与女性生殖道黏膜及口腔黏膜疾病发病关系的试验研究

目的：探讨单纯疱疹病毒感染与女性生殖道黏膜及口腔黏膜疾病的发病关系。方法：用多聚酶链反应(PCR)对33例口腔黏膜病患者和女性生殖道黏膜病患者病变局部涂抹标本进行了单独疱疹病毒DNA(HSV DHA)的检测。结果：其阳性检出率分别为85．7％和89．5％，总阳性率为87．5％，并且HSV感染口腔黏膜和女性生殖道黏膜的阳性感染率相接近，在二者间无显著性差异。结论：表明HSV感染与口腔黏膜疾病及女性生殖道黏膜疾病的发病有密切关系，HSV感染可能是引起黏膜疾病的一个触发因素。     

Parkinson's disease and anxiety

There has been a recent surge of interest in the subject of anxiety in patients with Parkinson's disease. Up to 40% of patients with Parkinson's disease experience clinically significant anxiety. This anxiety may be a psychological reaction to the stress of the illness or may be related to the neurochemical changes of the disease itself. Antiparkinsonian drugs may have a role in the pathogenesis of the anxiety. The anxiety disorders in Parkinson's disease patients appear to be clustered in the panic disorder, phobic disorder, and generalised anxiety disorder areas. The degree of comorbidity between anxiety and depression in patients with Parkinson's disease is in excess of that found in patients without the disease and anxiety in combination with depression may represent a specific depressive subtype in Parkinson's disease. As yet, there is no trial evidence as to the treatment of anxiety in patients with Parkinson's disease.     

Why alcoholism is not a disease.

OBJECTIVE: To expound the argument that alcoholism (or "problem drinking") is not best regarded as a disease. SUMMARY: Excessive drinking can cause physical disease and involve physical dependence without therefore being a disease itself. The "disease concept" of alcoholism is not needed to justify medical intervention or a caring approach to those who are dependent on alcohol. There is a specific and a general version of the disease concept of alcoholism. The specific disease concept, associated mainly with the Fellowship of Alcoholics Anonymous, is contradicted by empirical evidence and unhelpful for preventive and treatment responses to problem drinking, especially for the effort to detect and modify problem drinking at an early stage. The more general disease concept shares these disadvantages and is also ineffective in engendering sympathetic attitudes towards problem drinkers among the general public. It is more useful to view problem drinking as the result of the interaction between the individual's personality and the social context in which he or she has learned how to drink. CONCLUSION: For an effective and compassionate societal response to problem drinking, the disease model of alcoholism should be replaced by a social learning perspective.     

Rift valley fever

Rift Valley fever is a viral disease that affects domestic animals and humans. In humans, Rift Valley fever causes a flu-like disease but occasionally leads to high morbidity and mortality. The disease is generally known in the African continent. However, cases started to appear in Saudi Arabia and Yemen. The objective of this review is to give a general briefing about the epidemiology, ecology and management of the disease.     

World Kidney Day 2011 : protect your kidneys, save your heart

World Kidney Day is observed on March 10 every year and in 2011 the 6th annual event is going to be celebrated under the joint sponsorers - International Society of Nephrology and the International Federation of Kidney Foundations. The presence of chronic kidney disease significantly increases the risk of a cardiovascular event in both diabetes and hypertension. Proteinuria is always a marker of kidney disease. The time to development of a cardiovascular event is accelerated significantly by the presence of proteinuria at all levels of glomerular filtration rate. It is suggested that renal-targeted interventions designed to reduce proteinuria and slow progression of chronic renal disease can reduce cardiovascular disease. The biomarkers of chronic kidney disease (proteinuria, eGFR) are easy and relatively inexpensive to detect and one of these, proteinuria emerges early in the generalised vascular disease.     

新疆某院老年住院患者循环系统疾病统计分析

目的通过对新疆某院老年住院患者循环系统疾病资料分析,为老年患者治疗和预防循环系统疾病提供参考。方法以新疆某院2006-2010年收治的≥60岁老年人患者为对象,以国际疾病分类编码ICD-10分类,范围（I00-I99）。同一患者患有两种以上疾病时,均以出院第一诊断作统计对象。对疾病谱进行比较和分布描述。统计数据采用SPEL3.1统计软件处理。结果老年患者住院主要疾病为高血压、冠心病、肺心病和脑血管病。结论老年患者住院率高的年龄段是65-74岁,占老年住院人数的46.58%,高血压、冠心病、肺心病和脑血管疾病是威胁老年患者的主要疾病。     

椎动脉型颈椎病的发病机制

椎动脉型颈椎病是临床上一个常见病，其发病机理尚未完全明了。一般认为，机械压迫、颈交感神经受刺激及颈血管病变是引起该病的主要原因。现就近年来对椎动脉型颈椎病的发病机制的认识和研究作一综述。     

Paget's disease of bone

Paget's disease of bone is common, affecting up to 4% of Australians over the age of 55 years. The incidence of the disease and the severity of newly diagnosed cases appear to be falling, for unknown reasons. The cause of Paget's disease is unknown, but there is a strong genetic influence. Recently, mutations in the sequestosome 1/p62 gene have been identified as a cause of familial Paget's disease and of some apparently sporadic cases of the disease. The disease is often asymptomatic, but can cause bone pain, deformity, fracture and other complications. Paget's disease is eminently treatable. Potent bisphosphonates such as pamidronate, alendronate and risedronate relieve symptoms and may reduce the risk of complications. The Pharmaceutical Benefits Scheme subsidises treatment only for patients with symptomatic disease. A strong case be made for also treating asymptomatic patients with involvement of long bones, vertebrae or base of skull, patients with significant osteolytic lesions, and perhaps all younger patients.     

~(131)I治疗儿童和青少年Graves病的研究进展

Graves病是儿童和青少年甲状腺功能亢进的最常见病因,是由于遗传倾向、环境因素及免疫调节功能障碍等原因所致的一种综合征,影响儿童和青少年各个系统的发育成熟,特别是骨骼系统和神经系统,其自然缓解率低。目前治疗方法主要包括抗甲状腺药物、131I治疗及手术治疗。近年来,131I治疗在儿童和青少年Graves病的应用日渐广泛。现就131I治疗儿童和青少年Graves病存在的问题和远期安全性予以综述。     

超声检测肱动脉内皮功能的研究进展

内皮功能障碍是动脉粥样硬化的最早期改变,与心脑血管疾病的发生、发展密切相关。多普勒超声测定肱动脉血流介导扩张性可用来研究和评价血管内皮功能,在动脉粥样硬化的早期检测出内皮功能受损,对于早期发现心脑血管疾病、评估药物治疗效果、判断疾病的预后、预防心脑等重要器官产生终末期不可逆转的损害均有重要意义。本文对超声技术对肱动脉血管内皮功能的研究进展及应用价值进行综述。     

STUDY ON LEPTOTROMBIDIUM GAOHUENSIS SP. NOV. NEWLY DISCOVERED VECTOR OF TSUTSUGAMUSHI DISEASE

In 1957, a new tsutsugamushi disease vector, Leptotrombidium (L) Gaohuensis SP. Nov. was dis covered during an investigation of the disease in Gaohu Village, Zhejiang Province. An overall study of its epidemiology, ecology and etiology was corb ducted to determine the insect in function as a tsutsu gamushi disease vector. The authors conducted an insect bite test on themselves, showing that the larvac had the ability to bite humans and cause the infection. The second generation larvae were divided int0 5 groups of 5-20 larvae each and allowed to bite healthy mice. Two groups of the mice contracted the disease and died. Two strains of Rickettsia tsutsugamushi were isolated from them, and by electron microscopy, large quan tities of rickettsia parasites were found in the ovum with the ability to transmit Rickettsia tsutsugamushi. Isolation of Rickettsia Gaohuensis indicated that under suitable conditions. tsutsugamushi from L natural infection occurs L Gaohuensis is distributed throughout 10 counties in Zhejiang Province. It is a dominant species in the foci disease areas; its seasonal fluctua tion conforms to that of the disease and its ecological distribution also conforms with the disease incidence in the infectious areas. The findings indicate that L Gaohuensis fulfils all the criteria for a vector of tsutsugamushi disease, so it is concluded that L Gaohuensis SP. Nov. is a new vector for the disease.     

Essential hypertension: a sign in search of a disease.

The concept of disease is of cardinal importance in medical practice. The current definition has developed over more than 200 years. It includes a distinctive natural history and identifiable cellular changes. Pickering proposed a fundamental alteration to the definition when he suggested that essential hypertension is a quantitative disease without causative cellular change distinguishing normal from abnormal. The nature of essential hypertension has been confused from the beginning because of a category error. Injury is conceptually distinguished from disease. Essential hypertension, defined as elevated blood pressure together with its cardiovascular consequences, is found to be neither an injury nor a disease according to current definitions. Instead, essential hypertension refers to a treatment group just as "the fevers" did in an earlier century. One effect on patients of the failure to resolve this diagnostic paradox is the burden of suffering from the label of "disease" rather than from a state that may be substantially due to their own behavior. A theoretical consequence of importance for psychiatric theory is that the disease status of functional disorders can no longer be defended by an appeal to the existence of a quantitative disease of blood pressure.     

冠状动脉粥样硬化性心脏病介入治疗的研究进展

冠状动脉粥样硬化性心脏病(冠心病)是严重危害人类健康的常见病,也是全球病死率最高的疾病之一。冠心病的治疗方法包括药物治疗、介入治疗、外科手术治疗等,介入治疗是目前冠心病的常用治疗方法,其便于操作,危害性相对较小,术后恢复所需时间短,在突然发病的情况下可以迅速血管重建。该文简要介绍冠心病介入治疗的现状和进展情况。     

蜡泪样骨病1例并文献复习

蜡泪样骨病(Melorheostosis)是一种罕见起病原因不明的骨质硬化性疾病。发病率约为1/100万左右,早期无明显的临床特征,随着病情进展主要表现为受累肢体的慢性疼痛,活动时加重,且年龄越大疼痛越明显,严重者可出现受累肢体的感觉异常、关节挛缩、僵硬、畸形等。该疾病主要有保守治疗和手术治疗两种方式,一般愈后较好。此病发病较低,临床对此病认识不足,漏诊及误诊率较高。本文通过对我科收治的1例患者进行分析并复习相关文献,进一步熟悉蜡泪样骨病的的诊断和治疗方案,以提高对此病的认识。