神经性厌食及其心身医学综合治疗

1 病种简介--一种需要高度关注的"时代病" 神经性厌食(Anorexia Nervosa)是一种发病率越来越高但却常被误诊误治的心身疾病. 本文结合作者临床经验,介绍近期在"中德高级心理治疗师连续培训项目"集训中由德国专家Susanne Altmeyer博士提供的有关文献资料,并通过Askan Hendrischke教授主持进行的一次系统家庭治疗现场演示片段,展示德语国家心身医学的临床特色.     

碘缺乏病的防治

机体因缺碘而导致的一系列障碍，统称为碘缺乏病。由于机体缺碘的程度、缺碘持续的时间、缺碘时机体所处的发育阶段以及机体对缺碘的反应性不同，碘缺乏病可表现为不同的形式，包括地方性甲状腺肿、地方性克汀病（临床型、亚临床型）、流产、死胎，先天畸形及新生儿甲状腺功能减退等。其中，地方性甲状腺肿和地方性克汀病是其最主要的类型。     

糖尿病合并常见代谢性皮肤病的中西医治疗

糖尿病是全身性疾病，不仅能引起代谢障碍，同时可导致大小血管、中枢及周围神经等多种损害。皮肤做为全身最大的器官，具有丰富的血管、神经且代谢活跃。因此糖尿病患者皮肤易出现感染性皮肤病、代谢性皮肤病以及多种血管神经病变。目前临床总的治疗原则是控制血糖，调节血脂，保护病变皮肤，避免不良刺激，针对不同的病因及皮损表现采取相应的治疗方法。现将糖尿病合并常见代谢性皮肤病的中西医治疗介绍如下。     

碘过量与甲状腺疾病

介绍近年来国内外对高碘致甲状腺肿、甲状腺功能亢进症、甲状腺功能减退症、自身免疫甲状腺炎、甲状腺癌的研究进展,阐述防治碘缺乏病(IDD)应当因地因人分类设计,盲目补碘和过度补碘都是错误的。     

肾上腺组合性嗜铬细胞瘤四例报告及文献复习

Objective To discuss the clinical characteristics and management principles of com-posite pheochromoeytoma of adrenal gland (pheochromocytoma-ganglioneuroma). Methods Four cases of composite tumor of adrenal gland diagnosed pathologically were reviewed. All the cases were male, aged 37 to 62 years;three of them had the history of hypertension, one of them accompanied with paroxysmal palpitation, while one case was asymptomatic. Computerized tomography and ultra-sonography showed single tumor in adrenal, the diameter was about 2.5、3.8、6.3、15cm respectively. Two cases showed positive results in 131Ⅰ-metaiodobenzylguanidine (MIBG) scintigraphy. One case showed positive result in 99Tcm-hydrazinonicotinamide-3trysinoctreotide (HTOC) scintigraphy. Twenty-four hours urinary catecholamine examination revealed the average of norepinephrine, epi-nephrine and dopamine were (196.1±92.2)nmol/24 h, (26.6±8.9)nmol/24 h, (1957.9±913.5) nmol/24 h respectively. Two cases were at a little elevated level and the others with normal. All cases were managed with α-adrenergic receptor blocker preoperatively for 2-4 weeks. Results Tumor re-section was performed in all 4 cases, and 3 cases by retroperitoneal laparoscopy, one by open surgery. All 4 cases were diagnosed as composite pheochromocytoma of adrenal (Pheochromocytoma-gangli-oneuroma) by pathology. All patients had no evidence of recurrence or metastasis during follow-up from 15 to 38 months. Two of three cases with hypertension reverted to normotensive. Conclusions Composite pheochromocytoma of adrenal is rare, difficult to be diagnosed preoperatively. Except mild in eatecholamine secretion, which clinical manifestations are similar to pheochromocytoma. Pheochro-mocytoma-ganglioneuroma is no apparent tendency for aggressive behaviors, the results of surgical management are favorable.     

喜普妙致强迫性动作加重1例

报告1例喜普妙致强迫性动作加重如下:1　病例介绍患者女性,18岁,学生。因反复出现强迫性观念、强迫性行为2年入院。患者无诱因起病,表现为反复疑虑父母把不良的性格基因遗传给了她,经常在作文题目下反复划直线。明知没有意义而欲罢不能。并为此焦虑不安、痛苦万分,意志活动减退     

左室合并右室急性心肌梗死难治性休克2例

左室合并右室心肌梗死并非少见 ,但常被临床忽视并漏诊。合并心源性休克其早期诊断及采取相应的措施对疾病恢复至关重要。现将左室合并右室急性心肌梗死(ＡＭＩ)难治性休克 2例诊治体会报道如下。1　病例简介例 1:男 ,4 4岁 ,因持续性剧烈胸闷痛伴头晕大汗 3小时以“冠心病”收     

戈纳多瑞林诱导排卵

醋酸戈纳多瑞林(Gonadorelin acetate)是一种人工合成的十肽,其氨基酸顺序与人类促性腺激素释放激素(GnRH)完全相同,最近已由美国食品和药物管理局批准用于治疗原发性下丘脑性闭经。盐酸促性腺激素释放因子曾用于诊断,GnRH的类似物已用于子宫内膜异位和晚期前列腺癌的治疗。     

牙本质粘接剂间接盖髓的临床疗效

目的观察牙本质粘接剂在间接盖髓术中的疗效。方法选择102例牙合面深龋未直接露髓的患牙分别用Scotchbond2和Dycal间接盖髓,于术后6个月、12个月、24个月进行临床检查。结果牙本质粘接剂组2年成功率为91.8%,Dycal组为83.3%。结论牙本质粘接剂是一种较好的间接盖髓剂,可提高深龋治疗的成功率。