头痛、昏迷、抽搐、失明

头痛、昏迷、抽搐、失明关键词朊病毒病，尸检，鉴别诊断中国图书分类号Ｒ５ｌ２．３吉林化学工业公司职工医院病理科、神经内科白求恩医科大学第一临床医院神经内科１病历摘要患者女性，３４岁，工人。４ｄ前出现右颞部持续跳痛，阵发性加剧伴行为轻度异常，无发热、呕吐...     

反复牙龈出血、便血、经期延长、腹腔出血

1病历摘要患者女,47岁,因“反复牙龈出血、便血伴经期延长近40年,腹腔出血2年”入院。1.1病史患者1968年无诱因出现睡眠时牙龈出血,量多,止血药物治疗后出血停止。症状反复出现,未诊治。1970年无诱因出现便血,鲜红色,量多,曾一过性晕厥,外院予输血、止血治疗后好转。其后反复便中带鲜血,每月1~2次,量约10mL,自服止血药及中药可好转。1972年月经初潮,第二次月经持续约6周,量大,曾晕厥,外院查血Hb4g/L,诊为“功能性子宫出血”,予雌激素及止血治疗后,月经量稍有减少,输全血后月经量逐渐减少至停止。此后长期服用止血中药及雌激素,每月月经持…     

乏力、反应迟钝、肌肉疼痛、呼吸困难

１　病史摘要患者男性,６２岁,因乏力、阵发性手足抽搐半年,症状加重伴反应迟钝、吞咽困难、肌肉疼痛１个月,于１９９８年６月２９日入院。半年前无明显诱因出现乏力、阵发性手足抽搐,继而出现指端麻木、苍白,双膝关节僵硬,活动不灵。曾在某医院住院诊断为甲状腺功能减退,给予甲状腺片每日４０毫克口服,症状略好转出院。近１个月来上述症状加重,并出现反应迟钝,抬头无力,食欲减退,张口及吞咽困难,四肢肌肉疼痛,以下肢为重,同时伴有心悸、气短,门诊拟心包积液收住院。既往无肺结核、糖尿病、关节炎病史,无烟酒嗜好。体检：…     

孕早、中、晚期正常孕妇Zn、Ca、Mg、Fe分析

目的了解南京孕妇在不同孕期微量元素的变化规律。方法按孕周将547名孕妇分为早孕(小于16周)、中孕(16～28周)、晚孕(大于28周)3个实验组,130名正常体检妇女为对照组,采用原子吸收分光光度法检测孕妇及对照组妇女微量元素的含量,比较实验组及对照组微量元素值。结果随着孕周的增加,缺乏铁和镁的孕妇比例升高,钙元素早孕组缺乏的比例最高,中孕组孕妇缺锌比例最高。结论孕妇早孕期应注意钙元素的补充,中孕期应加强锌、镁、铁元素的补充,饮食上应注意膳食平衡,保证足够的微量元素铁供应。     

浮肿、发热、截瘫

患者女,34岁,因"浮肿1年余,发热3个月,双下肢瘫痪6天"入院.1病例摘要(第1部分)1.1病史患者于1年余前无明显诱因出现颜面及双下肢浮肿,伴脱发.查血常规WBC 3.2×109/L,Hb1O1 g/L,PLT 89 ×109/L,尿常规:蛋白5.0 g/L,24h尿蛋白定量4.03g,血A1b 25g/L,Cr正常,ANA、抗dsDNA(+),肾穿病理:狼疮性肾炎Ⅳ-S(A) +V型.诊断系统性红斑狼疮(SLE)给予泼尼松龙55 mg qd→每月减5mg,25 mg qd之后每月减2.5mg,来氟米特50 mg/d×3 d→20 mg qd维持.尿蛋白逐渐减少,浮肿、脱发逐渐减轻.1年前泼尼松龙减至40 mgqd时出现发热,多于上午出现,Tmax 39℃,下午自行降至正常,伴盗汗,中药治疗数日后体温正常.8个月前再次发热,性状同前,中药治疗约20d后体温正常.3个月前泼尼松龙减至15 mg qd时第3次发热,Tmax40℃,上午及夜间达峰值,可自行降至正常,伴盗汗、畏寒,偶有寒战,无咳嗽、咳痰.胸部CT提示"双肺结节,肺间质改变".考虑SLE病情活动合并肺间质病变,泼尼松龙加至30 mg qd,并加用左氧氟沙星,3d后体温正常.停抗生素后再次发热,将泼尼松龙改为早20 mg,晚10 nmg,至今未再发热.1个月前感乏力,行走无力,8d前双下肢无力明显加重,无法行走,伴感觉减退,大小便失禁,6d前双下肢完全瘫痪.否认结核接触史.既往史、个人史、月经婚育史、家族史:无殊.     

紫癜、发热、肉眼血尿、左侧偏瘫

1病历摘要 患者,女,27岁.因鼻衄、紫癜6年,发热、腰痛、肉眼血尿4个月,突发左侧肢体无力6天入院.     

皮疹、腹痛、腹泻、发热、球麻痹

患者,男,51岁.因"皮疹2年,脐周胀痛、腹泻半年余,加重伴高热5 d"入院. 1病历摘要 1.1病史 患者2005年7月无诱因出现左手腕部淡红色皮疹,直径约0.5 cm,凸出皮面,脱屑,轻度瘙痒,无疼痛.外用药(具体不详)治疗后皮疹渐消褪至褐色色素沉着.     

头昏、四肢无力、食呛、谈漠、语言不清

头昏、四肢无力、食呛、谈漠、语言不清安徽省铜陵市人民医院病理科皖南医学院病理学教研室１病史摘要患者，男，２０岁。因头昏、四肢无力，渐加重４０余日，食呛、语言不清、淡漠１０余日。发病前无明显诱因，病程中无发热。ＥＥＧ示中度异常双额区段慢波。拟诊“脑干脑...     

腹水、肾损害、心肌病变、免疫球蛋白减少

1病例摘要 患者女性,59岁,因“腹胀、乏力半年,加重1个月”于2011-05-23收入北京协和医院消化科.患者2010年10月无明显诱因出现腹胀、乏力,伴食欲减退、体重减轻.外院查血常规WBC 8×109/L,Hb104 g/L,PLT 5×109/L(磕碰后有皮肤出血点).肝功:ALT 59 U/L,AST 74 U/L,ALP 278 U/L,G,GT394 U/L,余(-);肾功:Cr 95 μmol/L(2010年11月),259 μmol/L( 2011年4月).免疫球蛋白IgG3.7 g/L,IgA 0.55 g/L,IgM 0.54 g/L.     

发热、咳嗽、浮肿、黄疸

病历摘要男孩,10岁。因不规则发热、咳嗽两个月,浮肿10余天,黄疸3d,于1987年4月28日入院。平素喜静,活动后乏力胸闷,无游走性关节疼痛。体检:体温37     

干细胞——起源不同调控相似

由于干细胞在白血病、老年性痴呆症、糖尿病等多种疾病的治疗以及动物克隆等方面显示出巨大的应用前景,干细胞研究已经成为当今生命科学领域的热点.     

汉,蒙,维,畲四民族DR4亚型的研究

为了解不同民族的ＤＲ４亚型，对９２例河北汉族、８０例西安汉族、５０例蒙古族、９２例新疆维族、９８例福建畲族进行了ＤＲ４亚型的比较研究。发现ＤＲＢ１＊０４０１等位基因频率在我国由北向南呈递减趋势，从蒙古族的１４．０％降至湖南汉族的１．５％。新疆维族存在着较高比例的白人基因ＤＲＢ１＊０４０４（６．６％）和ＤＲＢ１＊０４０１（５．５％）。福建畲族ＤＲＢ１＊０４０５（８．２％）、ＤＲＢ１＊０４０６（８．２％）的频率均较高而与河北汉族相近似。ＨＬＡ－ＤＲ４亚型的分布揭示出祖先民族迁移与融合的历史。     

ANGIOGENESIS IN NORMAL,HYPERPLASTIC, AND NEOPLASTIC ENDOMETRIUM

The purpose of this study was to quantify vascular density in the stroma of normal, hyperplastic, and neoplastic endometria and to explore its relationship to other prognostic features of endometrioid adenocarcinoma. Curettage specimens of proliferative and mid-secretory endometrium; simple, complex, and atypical endometrial hyperplasia; and grade I endometrioid adenocarcinoma were stained with Factor VIII-related antigen. The number of vessels per mm² of stroma was calculated for each case. The stroma of mid-secretory and hyperplastic endometrium was more vascular than that of proliferative endometrium. The stroma of adenocarcinoma, though reduced in proportion to the epithelium, was significantly more vascular than that of normal or hyperplastic endometrium. Stromal vascular density was not related to the depth of invasion, the presence of lymphovascular space permeation, or the state of the adjacent endometrium, whether atrophic or hyperplastic.     

IDEALS, BETRAYAL, GUILT AND FORGIVENESS IN COUPLE PSYCHOTHERAPY

ABSTRACT This paper is about the unconscious ideals couples share, and the dynamic effect of these on their relationships. With the aid of two detailed clinical examples, I examine how the unconscious ideals actually affecting couples' relationships are often quite different from couples' conscious ideas of their ideals, and, in particular, how couples can get fixated in paranoid-schizoid and regressive shared states of mind as a result. I explore the kind of psychological journey couples typically find they have to tread if they are to develop to ideals which are more rational and tolerant, borne of the depressive position. I note how couples' notions of betrayal and forgiveness are quite different according to whether they are relating from the paranoid-schizoid or depressive position.     

FOETO-MATERNAL COMPATIBILITY IN HLA-DR, -DQ,AND -DP LOCI IN FINNISH COUPLES SUFFERING FROM RECURRENT SPONTANEOUS ABORTIONS

The polymorphism of Major Histocompatibility Complex (MHC) class II genes DRB, DQA, DQB, and DPA was studied by Taq I Restriction Fragment Length Polymorphism (RFLP) in recurrent spontaneous abortions (RSA). The study group consisted of 35 primary abortion (PA) couples (no children) and 15 secondary abortion (SA) couples (1-2 children before abortions). We found no increase in DR-DQ compatibility between the mother and the foetus in the Finnish RSA group. In contrast to findings in some other populations, foeto-maternal incompatibility was increased in the PA group. Thus, our results do not support the theory that increased MHC class II compatibility is a cause of abortions as such. The Finns are a small and relatively isolated population with a unique gene inheritance. Thus, one can speculate that, if the human MHC class II is in the linkage with disadvantageous ‘fertility genes’, and these genes might nonetheless still be clustered in only a few MHC haplotypes among the Finns. This would be the reason, that DR-DQ sharing is not seen. The presence of rare HLA alleles, such as DR2 and DR6, among the aborters also supports this. In addition, this study extends our previous findings on MHC class III in regards to PA and SA couples differing immunogenetically from each other. In MHC class II, this was most obvious in the DPA1 locus. The vast majority of SA women were heterozygous for the two most common DPA1 alleles (14.0kb and 13.5kb), resulting in significantly smaller chances for a DPA1 mismatched foetus to occur in the SA group than in the controls or in the PA women.