Femoral hernia appendix causing small intestinal obstruction.

An 88 year old woman presented with a painful, irreducible right femoral hernia and small intestinal obstruction. At laparotomy, some distal small intestine was found to have twisted around an uninflamed appendix which was acting as a ''band'', with its tip fixed in the femoral hernia sac. Although the association between the appendix and femoral hernia is well recognized, the production of small intestinal obstruction by this particular mechanism has not been previously reported.     

五十岁人男女性头发老化度调查研究

本文对五十岁人男女性各25人,经过同一部位采发,观察了密度(lcm~2)、软毛数目及白发数目,抽查了毛小皮形态及毛系数。针对本组调查结果,初步确定以软毛数目为主要根据,参考白发数目,提出了五十岁年龄组老化度的初步意见。     

Holistic Approach to Functional Constipation: Perspective of Traditional Persian Medicine

Traditional Persian medicine (TPM) proposes a different viewpoint to the chronic diseases. Diagnosis and implemented treatment are based on individual differences among patients. Constipation or Ea''teghal-e-batn is a condition in which the patient develops difficult or painful defecation. Based on TPM concepts, the first digestion step starts from halq (oral cavity), and ends via defecation from the maq''ad (anus). Avicenna believed that four faculties, ha''zemeh (digestive), ja''zebeh (absorptive), ma''sekeh (retentive) and da''fe''eh (propulsive), are involved in the process of digestion and absorption of the ingested food and expelling the waste materials. The bowel movement and appearance of the stool is a measure for evaluating the gastrointestinal healthy function. Defecation should be with no pain and fecal material should have no burning and acuity. Low food intake or foods with dry temperament, dryness of gastrointestinal tract, diaphoresis and heavy exercise as well as intestine sensory loss were discussed as main causes of constipation. Management of constipation in TPM includes dietary schemes, oil massages and subsequently simple herbal medicines. According to TPM theories, the first step in treating a disease is the elimination of disease causes (asbab e-maraz) and also providing the causes of health (asbab-e-sehhat). Health care providers should know the proper condition which the herbal medicines should be administered in and be able to guide the patients about the benefits and hazards of herbal remedies, commonly used in their living origin.     

胎儿脐血管穿刺产前诊断100例临床分析

目的分析脐血管穿刺的安全性及脐血管穿刺产前诊断的临床意义。方法对开展的100例脐血管穿刺产前诊断进行回顾性研究。结果脐血管穿刺孕周21~36周,孕妇年龄21~39岁,穿刺成功率100%,诊断异常13例,符合率100%,胎盘穿刺点出血49例,脐带穿刺点出血15例,胎心过缓6例,胎儿宫内死亡1例。结论B超引导下脐血管穿刺是产前诊断的重要内容,合理选择适应证,规范操作,可降低母儿并发症发生率,具有重要的产前诊断意义。     

单绒毛膜单羊膜囊双胎脐带缠绕1例并文献复习

本文报道1例孕妇,孕期未规律产检,孕32+1 周因先兆早产首次就诊于我院,结合孕早期超声结果,诊断为单绒双胎,入院后给予硫酸镁保护胎儿神经系统、促胎肺成熟等治疗,于孕32+3 周行剖宫产术,术中娩出两活婴,长女头位娩出,体重1600 g,1 min Apgar 评分9 分（皮肤颜色减1 分）;次女臀位娩出,体重1700 g,1 min Apgar评分7 分（呼吸、肌张力、皮肤颜色各减1 分）,5 min Apgar 评分9 分（皮肤颜色减1 分）,两胎儿间无隔膜,胎盘娩出后见两脐带长约50/55 cm,脐带根部紧邻,两根脐带复杂缠绕6 周并呈脐带真结,手术顺利。患者术后恢复好,如期出院。长女因新生儿坏死性小肠结肠炎继发DIC,于儿科住院36 d 后家属放弃治疗,次女于儿科住院52 d后出院,现生长发育良好。     

S-ROM假体联合转子下截骨治疗Crowe Ⅳ型髋关节发育不良

目的 探讨采用S-ROM假体联合股骨转子下横形截骨行全髋关节置换术的方法,评价其对于治疗Crowe Ⅳ型成人髋关节发育不良疾病的疗效. 方法 收集11例(13髋)Crowe Ⅳ型髋关节发育不良患者,采用S-ROM假体联合股骨转子下横断截骨短缩法行全髋关节置换手术.采集双下肢长度差、髋关节活动度、改良Harris髋关节评分、简明健康调查表及髋关节X线片等相关临床资料进行对比分析. 结果 11例患者均得到有效随访,中位随访时间60月(8～78月).未发现感染、骨折、脱位等并发症.双下肢长度差术前为(25.2±7.6)mm,术后为(1.2±0.4)mm(t=10.481,P<0.01).改良Harris评分由术前的(38.2±6.4)分提高到术后(82.1±8.6)分,差别有统计学意义(t=14.186,P<0.01).影像学示假体固定优良,无临近骨质溶解表现.所有施行臼侧植骨及股骨截骨处均骨性愈合. 结论 S-ROM假体联合股骨转子下横形截骨行全髋关节置换术,对于恢复Crowe Ⅳ型成人髋关节发育不良患者髋关节功能、解除髋关节疼痛疗效确切,并能有效改善患者的生活质量.     

The role of surgery for pancreatic cancer: a 12-year review of patient outcome

Introduction

Pancreatic cancer has a poor prognosis with <5% alive at 5 years, despite active surgical treatment. The study aim was to review patients undergoing pancreatic resection and assess the effect of clinical and pathological parameters on survival.

Patients and methods

All patients who had undergone radical pancreatic surgery, January 1996 to December 2008, were identified from the unit database. Additional information was retrieved from the patient records. The demographic, clinical, and pathological records were recorded using Microsoft Excel. Survival was assessed using Kaplan-Meier and predictors of survival determined by multinominal logistic regression and log rank test.

Results

126 patients were identified from the database. The majority (106) had a Whipple''s procedure, 14 had a distal pancreatectomy and 6 had local periampullary excision. The average age of the Whipple''s group of patients was 61.7 years (± 11.7) with most procedures performed for malignancy (n=100). Survival was worse with adenocarcinoma compared to all other pathologies (p=0.013), while periampullary tumours had a better prognosis compared to other locations (p=0.019). Survival decreased with poorer differentiation (p=0.001), increasing pT (p<0.001) and pN stage (p<0.001). Survival was worse with perineural (p=0.04) or lymphovascular invasion (p=0.05). A microscopic postive resection margin (R1) was associated with a worse survival (p=0.007). Tumour differentiation (p=0.001) and positive nodal status (p<0.001) were found to be independent predictors of mortality.

Conclusion

Tumour differentiation and nodal status are important predictors of outcome. A positive resection margin is associated with a poorer survival.     

黑白头发mtDNA控制区的异质性差异研究

目的探讨黑头发和白头发线粒体DNA(mtDNA)控制区的异质性差异。方法提取毛干mtDNA,用PCR技术扩增mtDNA控制区5个目标片段,以变性高效液相色谱技术分析中国汉族正常人与Alzheimer病同个体黑头发和白头发mtDNA控制区目标片段的异质性差异。结果 30～40岁正常人、50～70岁正常人和50～70岁Alzheimer病患者黑头发mtDNA异质性分别为:3.2%、10.0%及16.4%;30～40岁正常人、50～70岁正常人和50～70岁Alzheimer病患者白头发mtDNA异质性分别为:7.2%、20.4%及28.0%,各年龄段正常人及Alzheimer病患者同个体白头mtDNA异质性明显高于黑头发。结论同个体中黑白头发和mtDNA控制区的异质性有明显差异,年龄越大,异质性越明显。     

非运动症状对帕金森病患者生活质量的影响

目的探讨非运动症状对帕金森病患者生活质量的影响。方法对45例帕金森病患者和50例中老年健康人群（对照组）采用帕金森病非运动症状问卷调查、简易智能精神量表、汉密尔顿抑郁量表、汉密尔顿焦虑量表、匹兹堡睡眠指数、阿尔茨海默病评定量表-认知部分、日常生活能力量表评定患者智能和抑郁、焦虑、睡眠、记忆、生活质量状况。结果帕金森病患者在智能、抑郁、焦虑、睡眠、记忆、生活质量方面均低于对照组。患者非运动症状与病程呈正相关,与智能、抑郁、焦虑、睡眠、记忆、生活质量呈负相关,与年龄、性别、发病年龄无相关。结论积极治疗帕金森病患者的非运动症状,加强心理干预是提高其生活质量不可忽视的重要方面。     

脐带绕颈胎儿脐动脉血气变化的研究

为了了解脐带绕颈胎儿脐动脉血气变化,选取228例孕37～42周孕妇,脐带绕颈组167例(按绕颈松紧程度分组),对照组61例,产后均行脐动脉血气分析.结果发现脐带绕颈较紧组有25例发生酸中毒,与对照组有显著性差异(P＜0.05);其中混合性酸中毒占66%,代谢性酸中毒占8%.提示脐带绕颈较紧胎儿酸中毒的发生率较高,以混合性酸中毒和代谢性酸中毒多见.     

不同年龄组老年人毛发老化度调查研究

本文对不同年龄组(50、60、70、80周岁)老年人(200人)毛发老化度进行了调查研究,并对新生儿50人及18岁男女青年50人的毛发进行了对照检查。主要检查了头发的密度、白发、软发的数目,眉毛的异常等。对其结果应用两种计算方法判定了老化度标准,做为不同年龄组老年人老化度指标之一。     

小鼠异位肢体复合组织移植模型的建立

目的：建立稳定的小鼠异位肢体复合组织移植模型。 方法：选用25对C57BL/6小鼠行同种同品系异位肢体复合组织移植手术。取供体小鼠后肢,于腹股沟韧带下缘起沿股动脉、股静脉向上游离,电凝切断除股静脉、股动脉外所有分枝血管至髂外动脉、髂外静脉,断髂外动脉、髂外静脉后,横断股骨、股部肌肉。将供体髂外动脉、髂外静脉分别与受体小鼠右侧颈总动脉、颈外静脉行端侧吻合。连续缝合供体皮缘于受体皮肤切缘固定肢体。于供肢胫骨远端关节处切断,结扎残端。 结果：手术成功率76%,总手术时间87.1?0.1min,供体获取时间23.8?.9min,血管吻合时间55.3?.6min。 结论：小鼠异位肢体复合组织移植成功率较高,稳定可靠,是一种新的研究移植免疫的理想的动物模型。     

Schmidt's syndrome – Case report

When immune dysfunction affects two or more endocrine glands and other non-endocrine immune disorders are present, the polyglandular autoimmune (PGA) syndromes should be considered. The PGA syndromes are classified as two main types: PGA type I and PGA type II. We are reporting this case in which a patient had primary adrenal insufficiency, autoimmune hypothyroidism and insulin dependent diabetes mellitus and was diagnosed as "Schmidt''s syndrome" (PGA type II). This syndrome is a very rare autoimmune disorder and difficult to diagnose because the symptoms of this syndrome depends on the gland which gets involved first. Our patient was treated and improved with corticosteroid, thyroxine and insulin therapy.     

A patient with Graves' disease who survived despite developing thyroid storm and lactic acidosis

A 56-year-old woman with Graves'' disease presented with the complaints of diarrhea and palpitations. Physical examination and laboratory data revealed hypothermia and signs of mild hyperthyroidism, heart failure, hepatic dysfunction with jaundice, hypoglycemia, and lactic acidosis. The patient was diagnosed as having developed the complication of thyroid storm in the absence of marked elevation of the thyroid hormone levels, because of the potential hepatic and cardiac dysfunctions caused by heavy alcohol drinking. A year later, after successful treatment, the patient remains well without any clinical evidence of heart failure or hepatic dysfunction. Thyroid storm associated with lactic acidosis and hypothermia is a serious condition and has rarely been reported. Prompt treatment is essential even if the serum thyroid hormone levels are not markedly elevated. We present a report about this patient, as her life could eventually be saved.     

关于针对SARS的综合免疫治疗策略

采用鼻腔喷雾法(CCID50=105.7)研究了SARS冠状病毒(SARS-CoV)对成年和幼年布氏田鼠的感染效果.成年动物攻毒后出现死亡,表现为口鼻有出血,肠道出血;肺组织呈出血性间质性肺炎改变,肝、脾、肾、胰腺组织均呈淤血性改变;存活动物肺组织呈间质性肺炎,局灶出血及肺气肿改变,其他脏器未见明显病变.幼年动物攻毒后未见死亡但行动较为迟缓,主要脏器未见明显异常;早期肺组织有局限性肺炎改变,且病毒分离为阳性;同居对照组的一只动物有肺组织局灶性肺炎.结果表明,SARS-CoV可以很强地感染布氏田鼠;成年布氏田鼠比幼年动物对SARS-CoV更敏感;布氏田鼠有望成为一种比较理想的小型SARS动物模型。     

Dermoid cyst in a domestic shorthair cat

A 5-year-old neutered male domestic shorthair cat was presented for examination of a subcutaneous mass in his tail. The mass was firm, non-painful, oval, and approximately 2.5 × 3.5 cm. Surgical exploration revealed a well-circumscribed, encapsulated mass. The mass was removed and sectioned for histopathological examination. In gross section, it was filled with numerous dark hairs. Histologically the mass was consisted of haired skin with dermal cystic structures lined by stratified squamous epithelium. The cyst lumen contained squamous debris and filled with keratinous material. Numerous hair shafts were extended from the wall of the cyst. The sebaceous and apocrine gland adnexal structures were also observed which confirmed the diagnosis of dermoid cyst. No tumor recurrence was observed after surgery in fallowing checkups. Cutaneous or subcutaneous cysts of all types are considered rare in cats and to our knowledge this is the third reported case of cutaneous dermoid cyst of cats in veterinary literature which is different from the other cases because it occurred in dorsal midline in tail area whereas others occurred in flank area.     

Sheehan's syndrome presenting as psychosis: a rare clinical presentation

Sheehan''s syndrome (SS) refers to the occurrence of varying degree of hypopituitarism after parturition (1). It is a rare cause of hypopituitarism in developed countries owing to advances in obstetric care and its frequency is decreasing worldwide. However, it is still frequent in underdeveloped and developing countries. Sheehan''s syndrome is often diagnosed late as it evolves slowly (2,3). Reports of psychoses in patients with Sheehan''s syndrome are rare. Herein, a case report of psychosis in a 31 year old woman who developed Sheehan''s syndrome preceded by postpartum haemorrhage is presented. Treatment with thyroxine and glucocorticoids resulted in complete remission after attaining euthyroid and eucortisolemic state.     

广西青年白发人群的人类学调查研究

目的　探讨广西青年白发人群的人类学特征 ,为人类学、民族学和医学应用提供科学依据。方法　按人类学的方法和标准对广西青年白发人群 2 80人进行活体观察和调查。结果　广西青年白发人群头发形状均为直发 ;发旋以单旋、顺时针方向和位在头顶中线为多 ;头发密度中等以上 ;大部分人在 16～ 2 5岁之间有白发 ;父母青年时无白发者占5 3 %～ 60 %,祖父母青年时无白发者占 77%～ 79%。 82 %的白发者认为自身白发主要与精神因素有关。结论　广西青年白发主要与精神因素、遗传以及营养、民族发色和头发形状有关。     

中药大蓟及其2种伪品的微性状鉴别

目的 鉴别市场上大蓟及其2种伪品。方法 通过微性状鉴定法对大蓟及其伪品进行观察研究。结果 蓟的茎、叶均被蛛丝毛及多细胞长节毛,苞片两面及边缘均被毛,花丝亦被毛,花药顶端呈长三角形,冠毛顶端呈纺锤形扩大或渐细;刺儿菜茎、叶仅被蛛丝毛,苞片内面无毛,花药顶端呈削尖状,冠毛顶端渐细;花叶滇苦菜茎、叶以及苞片均无毛,花丝光滑,花药顶端呈黑色,花冠被长毛,果实边缘具齿。结论 微性状鉴定法可准确、快速地鉴别大蓟及其伪品。     

曲唑酮治疗阿尔茨海默病伴睡眠障碍患者的疗效及对患者认知功能的影响

目的 探讨曲唑酮治疗阿尔茨海默病(AD)伴睡眠障碍患者的疗效及其对患者认知功能、海马体积、日常生活能力的影响.方法 选取2018年10月—2019年10月在湖州市第三人民医院就诊的AD伴随睡眠障碍患者70例为研究对象.将70例患者随机分为观察组(口服多奈哌齐+曲唑酮)和对照组(口服多奈哌齐+唑吡坦),每组35例.用MR...