女性高雄激素血症三例

多种卵巢、肾上腺疾病可引起女性体内雄激素水平升高。本文回顾性分析了天津医科大学总医院 2016年 7 月—2017 年 1 月收治的诊断明确的 3 例女性高雄激素血症患者的诊治过程,从不同角度探讨引起女性高雄激素血症的原因。     

Three cases of fatal paramethoxyamphetamine overdose

Two recent cases of death due to paramethoxyamphetamine (PMA), a methoxylated phenylethylamine derivative, are described and compared with a previous PMA death that occurred in this province in 1985. The deceased were 18 or 19 years of age and were reported to have ingested either methylenedioxymethamphetamine (MDMA, Ecstasy) or methylenedioxyamphetamine (MDA) prior to their deaths. Concentrations of PMA were measured in both peripheral and heart blood samples using gas chromatography equipped with a nitrogen-phosphorus detector. PMA results in the most recent cases were 0.6 mg/L and 1.3 mg/L in the peripheral blood samples, and corresponding heart blood samples were 0.7 mg/L and 2.3 mg/L, respectively. In the 1985 case, the femoral blood concentration was 0.6 mg/L, and the heart blood concentration was 0.8 mg/L. Significant differences between heart and peripheral blood concentrations were observed in two of the three cases, which may indicate the potential for postmortem redistribution of PMA.     

单硝酸异山梨酯致晕厥3例

晕厥（syncope）是大脑半球或脑干血液供应不足，导致突发短暂意识丧失伴姿势性张力丧失综合征。药源性晕厥发生率为2％～9％，以年老体弱的女性多见。我们最近在临床治疗中发现3例由单硝酸异山梨酯（丽珠欣乐）所致的晕厥，现报告如下，以期为临床安全用药提供参考。     

Three eyelid localized cutaneous anthrax cases

Anthrax is primarily seen in the developing countries, but it can be a worldwide medical concern due to bioterrorism threats. Palpebral anthrax is a rare form of cutaneous anthrax. Untreated cutaneous anthrax can be lethal. Patients with palpebral anthrax can develop complications including cicatrisation and ectropion. Thus, anthrax should be considered in differential diagnosis for patients presenting with preseptal cellulitis in high-risk regions. Herein, we report three anthrax cases (with different age) involving eyelids that were cured without any complications due to early diagnosis and treatment.     

干扰素治疗乙肝致蛋白尿3例

干扰素具有抗病毒、抗肿瘤和免疫调节作用,是治疗病毒性疾病、恶性肿瘤的有效药物,也是目前治疗慢性乙型病毒性肝炎最有效的药物之一[1],但其不良反应不容忽视,其中流感样综合症、外周血异常、中枢神经系统反应等为常见的不良反应[2],但干扰素会导致某些患者出现蛋白尿,这种不良反应却鲜有报道,笔者在工作中发现了3例,现报告如下:……     

白血病关节炎三例分析并文献复习

目的提高对白血病关节炎的认识并与其他类型的关节炎进行鉴别。方法对我院收治的3例白血病关节炎病例进行分析和总结,同时结合文献复习与国内外的相关文献进行比较。结果白血病关节炎具有不同于一般关节炎的一些临床特征,包括关节疼痛重、肿胀轻,但偶有大量关节积液;常伴乳酸脱氢酶显著增高;非甾体抗炎药效差,但化疗有效。结论白血病关节炎需要统一诊断标准,以便引起风湿病专科和血液病专科医师的重视,从而使白血病关节炎成为某些白血病早期诊断的重要线索,使白血病得到早期诊断及治疗。     

Three cases of Zigadenus (death camus) poisoning

Three cases are reported where 1/2-2 bulbs of Zigadenus were ingested. This resulted in vomiting, cramping and nausea, starting within 1-2 hours and lasting 4-5 hours. Both the heart rate and blood pressure were affected, generally, but not consistently, decreased. Atropine, when used for the cardiovascular effects, increased the heart rate, but had minimal action on the blood pressure. There was little toxic effect on respiration, central nervous system, or temperature. The one case of increased temperature was though to be due to an unrelated illness. Treatment of such cases should include emesis (or lavage, if emesis is contraindicated), activated charcoal, and saline cathartic. Symptomatic cases need an iv and possible administration of atropine, a sympathometic and/or a ganglionic blocking agent. Since there is considerable variation in what symptoms will be seen with the different species of Zigadenus, each case must be treated symptomatically; first with good supportive care, then possibly with administration of the above agents.     

长春新碱化疗方案引起神经毒性反应3例

2例男性和1例女性患者,年龄分别为17、30、14岁,因急性淋巴细胞白血病给予长春新碱、吡柔比星及泼尼松化疗.治疗1～2周期时,患者出现四肢麻木、肌力下降、手指不能完全伸直、双手指间关节和掌指关节活动受限,以及四肢肌肉萎缩.给予VitB1、VitB12和甲钴铵治疗后,患者症状略有好转.     

静滴双黄连注射液致不良反应3例

双黄连注射液系纯中药制剂,由金银花、连翘、黄芩提取精制而成,具有抗菌、抗病毒作用,已成为临床上用于治疗外感风热引起的发热、咽痛、咳嗽等上呼吸道感染及急慢性咽喉炎、支气管炎等症的常用药物,随着应用的广泛,不良反应也逐渐增多。本文报道的3例静滴双黄连注射液引起的不良反应,供临床参考。1致静脉炎1例患者,男,31岁,汉族,体重75公斤。因上呼吸道感染来诊,给予双黄连注射液40 ml加入250 ml氯化钠注射液中静滴。两天后,患者输液之血管出现红肿发硬,遂停药,经过3天的热敷患处治疗后,症状痊愈。2致皮肤过敏反应1例患者,男,36岁,汉族,体重…     

胃癌根治术后肠套叠 3例临床治疗分析

目的通过分析胃癌根治术后并发肠套叠 3例病人的临床诊断与治疗方法,为进一步对胃癌根治术后并发肠套叠的及时诊断与治疗提供帮助。方法回顾性分析 2018年 10月至 2019年 3月安徽医科大学第一附属医院行胃癌根治术后并发肠套叠 3例病人的临床资料。结果 3例病人均为老年进展期胃癌病人,分别于术后第 36、19、13天发现肠套叠,均行手术治疗切除套叠肠管,均顺利出院。结论胃癌根治术后并发肠套叠较其他胃癌术后并发症发生率低,起病缓慢,易误诊为术后肠梗阻而耽误治疗;腹盆腔 CT、上消化道碘水造影检查能够帮助进一步确诊;一旦诊断,及时手术治疗效果较好。     

胰岛素自身免疫综合征3例报告及文献复习

目的 总结分析国内胰岛素自身免疫综合征(insulin autoimmune syndrome,IAS)病人的临床资料,以期提高临床对IAS的认识.方法 对2013年6月至2018年12月于西安高新医院确诊为IAS的3例病人和2009年6月至2019年6月于各大数据库中检索到关于IAS的87例国内个案报道进行回顾性分析...