腹泻,血便,干咳,浮肿,昏迷

病历摘要患儿，男，7岁。因腹泻、腹痛、血便6周，干咳、下肢浮肿2周，于1990年5月15日入院。1990年4月3日，患儿开始腹泻，大便由3～4次／日增加到10次／日以上，粘液糊状便，量较多，混有少量鲜血，伴脐周阵发性隐痛、腹胀及恶心呕吐，低热，体温37．3℃～38℃，无里急后重。     

毛磊,王静凤,陈鹏,张昕,王一名,常耀光,薛长湖*

目的 研究梅花参岩藻聚糖硫酸酯(Fucoidan from Thelenota ananas,Ta-FUC)对高脂高果糖诱导的胰岛素抵抗模型小鼠慢性炎症的改善作用及相关信号通路。 方法 采用高脂高果糖饲喂C57BL/6小鼠,建立胰岛素抵抗模型。雄性C57BL/6小鼠随机分为6组：正常对照组、模型对照组、阳性对照组(RSG,1 mg/(kg.d))、Ta-FUC低剂量组(20 mg/(kg.d))和Ta-FUC高剂量组(80 mg/(kg.d))。连续饲喂13 wk后,检测各组小鼠血糖、胰岛素和炎症因子水平以及炎症信号通路NF-κB中关键基因mRNA的表达。 结果 Ta-FUC能显著降低小鼠体脂比,显著降低空腹血糖和空腹血清胰岛素水平,提高葡萄糖和胰岛素耐受水平。显著降低血清促炎因子FFA、TNF-α、IL-6、抵抗素、瘦素和CRP含量,显著提高血清抗炎因子IL-10和脂联素含量。显著下调NF-κB信号通路关键基因Ikkβ和NF-κB mRNA的表达量,上调NF-κB抑制物I-κBα mRNA的表达量。结论 梅花参岩藻聚糖硫酸酯通过抑制炎症信号通路NF-κB,显著改善胰岛素抵抗模型小鼠的慢性炎症。     

Interspecies scaling of excretory amounts using allometry – retrospective analysis with rifapentine,aztreonam, carumonam,pefloxacin, miloxacin,trovafloxacin, doripenem,imipenem, cefozopran,ceftazidime, linezolid for urinary excretion and rifapentine,cabotegravir, and dolutegravir for fecal excretion

1.?Interspecies allometry scaling for prediction of human excretory amounts in urine or feces was performed for numerous antibacterials. Antibacterials used for urinary scaling were: rifapentine, pefloxacin, trovafloxacin (Gr1/low;?<10%); miloxacin, linezolid, PNU-142300 (Gr2/medium; 10–40%); aztreonam, carumonam, cefozopran, doripenem, imipenem, and ceftazidime (Gr3/high; >50%). Rifapentine, cabotegravir, and dolutegravir was used for fecal scaling (high; >50%).

2.?The employment of allometry equation: Y?=?aW^b enabled scaling of urine/fecal amounts from animal species. Corresponding predicted amounts were converted into % recovery by considering the respective human dose. Comparison of predicted/observed values enabled fold difference and error calculations (mean absolute error [MAE] and root mean square error [RMSE]). Comparisons were made for urinary/fecal data; and qualitative assessment was made amongst Gr1/Gr2/Gr3 for urine.

3.?Average correlation coefficient for the allometry scaling was >0.995. Excretory amount predictions were largely within 0.75- to 1.5-fold differences. Average MAE and RMSE were within ±22% and 23%, respectively. Although robust predictions were achieved for higher urinary/fecal excretion (>50%), interspecies scaling was applicable for low/medium excretory drugs.

4.?Based on the data, interspecies scaling of urine or fecal excretory amounts may be potentially used as a tool to understand the significance of either urinary or fecal routes of elimination in humans in early development.     

腹痛,发热,昏迷

病例报告 患者 女,22岁,已婚。主因间歇性腹痛4个月加重5天,于1985年1月22日入院。入院前4个月无诱因出现不规律腹痛,以左下腹为主,大便正常,食欲尚可,能操劳一般家务。2个月前腹痛发作较前频繁,偶有恶心呕吐,呕吐物系胃内容,伴有低热。曾去本市几家医院就诊,均未明确诊断,院外用药不洋,治疗效果不明显。于入院前5天腹痛加剧,不能进食,进食即吐,少尿,能排气。我院急症室诊断:(1)     

爱滋病,免疫,中医药

本文叙述1988年10月在美国加里福尼亚召开的美国汉方医药研究所第九届年会学术论文录(1989、2)“爱滋病·免疫·中医药”的摘要。并写后记——传统中医的临床研究。美国汉方医药研究所(美国,加福尼亚州)系许鸿源教授创立,现任该所董事长、中国文化大学和中医学院植物学教授,发表了27种传统中医药专著,创办了87期该所学报(OHAI Bulletin)(今更名Journal of Oriental Medicine)刊载有关中医药的论文,包括中医经典著作的翻译,中药及其方剂的鉴定等内容。最近还将出版“爱滋病的研究”;“舌苔诊断”、“八纲”等专著。对中国传统医药文化传播西方,作出了重大的贡献。本文曾于1989年10月在四川江油召开的中国药学会四川分会学术年会大会上和1990年10月5日于华西医医科大学80周年校庆学术报告会上传达。     

甲,乙,丙,丁,戊型肝炎诊断进展

本文综述了甲、乙、丙、丁、戊型肝炎的诊断进展，分析了各种常规检测方法的优缺点，介绍了分子生物学技术在肝炎诊断中的应用。作者指出，聚合酶链反应（ＰＣＲ）技术及其与液相杂交或ＤＮＡ印迹试验的结合使用，为丙型肝炎病毒（ＨＣＶ）感染的诊断提供了非常有效的方法。     

发热,头痛,昏迷

病史摘要患者男性，47岁，工人，苏州市人，住院号19297。1994年12月23日发热起病，最高达39．7C，伴有头痛、恶心，无咳嗽、咳痰。院外抗炎治疗无效，病后第11天出现意识障碍，未见抽搐和肢体活动障碍，第14天入我院时神志陵陇，瞳孔等大（Zmm），光反应好，眼底正常，可见四肢活动，左侧Chadock（土），颈有抵抗，克氏征（士）。其它系统检查未见明显异常，体温36．SC。既往有“胃溃疡”和“阑尾炎”病史，余无特殊。辅助检查中，腰穿CSF压力290mmH。O，无色透明，WBC60个／mm‘，以淋巴细胞为主，蛋白1．84召儿，糖2．3mmol／L，氯…     

小米,鸡心,物美价廉

小米也被称为谷子、粟、稷等,是我国北方居民两千年来的传统主食,直到近代才退出第一主食的位置.小米特别出色的地方,是它的铁和维生素B1含量优于小麦、大米和玉米,特别适合孕妇、哺乳期女性食用.小米的膳食纤维含量在粗粮中偏低,口感细腻而容易消化,适合6个月后的婴幼儿吃.小米比大米还容易煮熟,可单独熬煮成粥,也可添加大枣、红豆、燕麦片、莲子、百合等,熬成风味各异的营养粥品.     

Efectsofmoxonidineinjectedintorostralventrolateralmedulaonbloodpressure,heartrate,andrenalsympatheticnerveactivityinrats

目的：观察延髓腹外侧头端（ＲＶＬＭ）注射莫索尼定（Ｍｏｘ）对麻醉大鼠血压（ＢＰ）、心率（ＨＲ）及肾交感神经放电（ＲＳＮＡ）的影响．方法：麻醉大鼠ＲＶＬＭ注射１μＬＭｏｘ１，１０，１００μｍｏｌ·Ｌ－１，同步记录ＢＰ，ＨＲ及ＲＳＮＡ．结果：Ｍｏｘ１，１０，１００μｍｏｌ·Ｌ－１分别使ＢＰ从１３９±１０ｋＰａ降至１３０±１７ｋＰａ（Ｐ＜００５），１３８±１８ｋＰａ至１１４±１５ｋＰａ（Ｐ＜００１），ａｎｄ１３９±１９ｋＰａ至９４±１７ｋＰａ（Ｐ＜００１）．Ｍｏｘ不影响ＨＲ．Ｍｏｘ１μｍｏｌ·Ｌ－１增加ＲＳＮＡ５０％（Ｐ＜００５），１０μｍｏｌ·Ｌ－１对ＲＳＮＡ无影响（Ｐ＞００５），１００μｍｏｌ·Ｌ－１则降低ＲＳＮＡ２３％（Ｐ＜００５）．在缓冲神经切断大鼠，Ｍｏｘ１０μｍｏｌ·Ｌ－１抑制ＲＳＮＡ５０％（Ｐ＜００５），明显不同于缓冲神经完整的动物（Ｐ＜００１）．结论：麻醉大鼠ＲＶＬＭ注射Ｍｏｘ可降低ＢＰ，但不影响ＨＲ，且ＲＳＮＡ变化与其降压作用并不平行     

高热,谵安,呼吸困难,皮肤出血点

1 病例报告 患者 男,32岁,因高热、谵妄、皮肤出血点5天于1995年1月14日住院。患者于1月10日突然出现寒战,高热(40℃以上)持续不退,伴头痛、全身肌肉剧痛、躁动、谵妄于外院就诊。当日血白细胞19.4×10~9/L,中性粒细胞0.90,淋巴细胞0.10。1月11日血AST 270 Iu/L,CK 1912 Iu/L,CK-MB 38 Iu/L,LDH 438 Iu/L,羟丁酸脱氢酶(HBDH)408 Iu/L。血肌酐(CRE)206μmol/L。按“感     

Evidence-based treatment: Why,what, where,when, and how?

Research and clinical perspectives are blended in this commentary on the rapidly emerging requirement for evidence-based treatment (EBT) in substance abuse programs. Although, historically, it has not been a standard of care in behavioral health, there are sound scientific, ethical, and compassionate reasons to learn and deliver an EBT as it becomes available. This article explores a series of issues, including the following: (1) Why should EBTs be used in substance abuse treatment? (2) What kinds of treatment are EBTs, and how are they determined? (3) Where can EBTs be implemented—at what levels of service delivery? (4) When should EBTs be used? and (5) How do clinicians learn EBTs? Potential pitfalls in implementing EBTs are also considered.     

What remains against carbapenem-resistant Enterobacteriaceae? Evaluation of chloramphenicol,ciprofloxacin, colistin,fosfomycin, minocycline,nitrofurantoin, temocillin and tigecycline

Carbapenem-resistant Enterobacteriaceae present an increasing and diverse problem, including strains of multiple species with metallo-β-lactamases (IMP, NDM or VIM) and non-metallo (KPC and OXA-48) enzymes as well as those combining an extended-spectrum β-lactamase (ESBL) or AmpC enzyme with porin loss. Most strains, except those with OXA-48 alone, are broadly resistant to β-lactams and have multiple aminoglycoside-modifying enzymes; those with NDM-1 carbapenemase typically also have 16S rRNA methylases, conferring complete aminoglycoside resistance. In this study, the activity of chloramphenicol, ciprofloxacin, colistin, fosfomycin, minocycline, nitrofurantoin, temocillin and tigecycline was evaluated against 81 carbapenem-resistant Enterobacteriaceae isolates from the UK. Testing was performed by the Clinical and Laboratory Standards Institute (CLSI) agar dilution method. Chloramphenicol, ciprofloxacin and nitrofurantoin inhibited <25% of the isolates at the breakpoint, whereas colistin was active against 75/81 isolates (92.6%), the exceptions being four Klebsiella pneumoniae and Enterobacter cloacae isolates along with members of inherently resistant genera. Fosfomycin was active against 49/81 isolates (60.5%), including 7/7 Escherichia coli, 16/20 Enterobacter and Citrobacter spp., but only 25/52 Klebsiella spp. Tigecycline was active against 38/81 isolates (46.9%) and was intermediate against another 27 (33.3%), with resistance scattered amongst K. pneumoniae and Enterobacter spp. The activity of colistin, fosfomycin and tigecycline was unrelated to the isolates' carbapenem resistance mechanisms. Temocillin was fully active [minimum inhibitory concentration (MIC) ≤8 mg/L] against only 4/81 isolates (4.9%), but inhibited a further 22 isolates (27.2%) at the British Society for Antimicrobial Chemotherapy (BSAC) urinary breakpoint (32 mg/L), predominantly comprising those isolates with combinations of impermeability and an ESBL or AmpC enzyme, along with 6/11 isolates producing KPC carbapenemases. Studies with transconjugants and transformants confirmed the small effect of KPC enzymes against temocillin, whereas OXA-48 and NDM-1 conferred clear resistance.     

发热,舌、口腔溃疡,四肢关节酸痛,红斑

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