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Xu Ren Chun-Lan Zhu Xu-Fu Qin Hong Jiang Tian Xia Yong-Ping Qu 《World Journal of Clinical Cases》2019,7(1):102-108
BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB) is pathologically similar to intraductal papillary mucinous neoplasm(IPMN). However, there are several significant differences between them. The rate of IPMN associated with extrapancreatic malignancies has been reported to range from 10%-40%, and it may occasionally be complicated with the presence of fistulas. IPMN associated with malignant IPNB is extremely rare and only nine cases have been reported in the literature.CASE SUMMARY We report a 52-year-old man who presented with recurrent cholangitis for nine months. Computed tomography and magnetic resonance cholangiopancreatography showed the common bile duct stricture with dilated pancreatobiliary duct without other abnormal findings. The underlying pathogenesis could not be identified based on the radiologic images. Endoscopic retrograde cholangiopancreatography revealed a pancreatobiliary fistula with dilated main pancreatic duct, biliary stricture with dilated biliary tree, and mucus discharge from the enlarged orifice of the major papilla. The patient underwent SpyGlass cholangiopancreatoscopy due to a suspected mucin-producing biliary neoplasm and indeterminate main pancreatic duct dilatation. Multiple papillary growing neoplasms with vascular images, with the extent of lesions spreading in the biliopancreatic ductal lumens, were identified by SpyGlass. In addition, the presence of a pancreatobiliary fistula was also identified. The patient was diagnosed as having benign IPMN and malignant IPNB with focal invasion by postoperative pathology. Furthermore, varying histological subtypes were present in both IPMN and IPNB. Pylorus-preserving pancreaticoduodenectomy was performed on the patient with excellent results during the 52 month followup period.CONCLUSION We deemed that pancreatography and SpyGlass allowed for an efficient diagnosis of IPMN with pancreatobiliary fistula, whereas the etiology could not be identified by radiologic imaging. 相似文献
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脐尿管瘘是一种膀胱畸形疾病,男性多见.临床表现为脐部漏尿,漏尿程度视瘘管的大小而定,脐部漏口为皮肤或黏膜所覆盖.静脉注射靛胭脂或从尿道导管将亚甲蓝注入膀胱,可见染色尿液自脐部漏出,故可诊断[1]. 相似文献
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对自由基和抗氧化剂的基本知识,自由基在ICU常见疾病发生发展中的作用以及抗氧剂的临床应用四方面内容进行综述,提示了ICU护士了解这四方面内容是临床实践的组成部分. 相似文献
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1病例介绍患者女,67岁。因"发热半个月,黑便1d"于2006年6月9日入院。患者半个月前起发热,多次测得体温≥39.0℃,无寒战,无咳嗽、咳痰,无腹痛、腹泻,无尿急、尿痛,无腰痛、咽痛,当地医院予抗生素、激素治疗体温反复,昨日起解黑便,共2次,伴头晕,晕厥1次,无呕血,为进一步诊治转入本院。既往类风湿关节炎 相似文献
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代谢综合征又称代谢异常心血管综合征,它是一组心血管疾病危险因素的聚集和组合,包括高血压、高血脂(血脂异常)、高血糖(糖尿病、血糖调节受损、糖耐量异常)、肥胖、吸烟、炎症、血凝增强、纤溶降低等。心血管疾病是人类头号杀手,给社会和家庭带来了沉重的经济负担。对于心血管疾病这种新的流行病学表现, 相似文献
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Jun-Hui Guo Yuan-Yuan Wang Jiang-Wei Zhang Pei-Min Liu Yan-Jun Hao Hai-Rui Duan 《World Journal of Clinical Cases》2020,8(7):1326-1336
BACKGROUND Apatinib is a small-molecule multitargeted tyrosine kinase inhibitor.Apatinib has demonstrated encouraging antitumor activities.This study aimed to observe the efficacy and safety of apatinib for the treatment of multiple brain micrometastases.CASE SUMMARY We report two patients with multiple brain micrometastases after failure of second-line treatment.Both patients had extracerebral metastases.When the patients took 250 mg/d apatinib orally,the intracerebral lesions disappeared.The extracerebral lesions were partially alleviated.Both patients had a progressionfree survival of more than 12 mo and were still stable.The safety was good.The main adverse events(AEs)were mild hypertension and proteinuria,which could be controlled.CONCLUSION Apatinib has clear efficacy and good tolerance in patients with multiple brain micrometastases after failure of second-line treatment. 相似文献
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BACKGROUND:
Despite the fact that traditional Chinese medicine (TCM) has been developed and used to treat acute and urgent illness for many thousands of years. TCM has been widely perceived in western societies that TCM may only be effective to treat chronic diseases. The aim of this article is to provide some scientific evidence regarding the application of TCM in emergency medicine and its future potential.METHODS:
Multiple databases (PubMed, ProQuest, Academic Search Elite and Science Direct) were searched using the terms: Traditional Chinese Medicine/ Chinese Medicine, Emergency Medicine, China. In addition, three leading TCM Journals in China were searched via Oriprobe Information Services for relevant articles (published from 1990—2012). Particular attention was paid to those articles that are related to TCM treatments or combined medicine in dealing with intensive and critical care.RESULTS:
TCM is a systematic traditional macro medicine. The clinical practice of TCM is guided by the TCM theoretical framework – a methodology founded thousands of years ago. As the methodologies between TCM and Biomedicine are significantly different, it provides an opportunity to combine two medicines, in order to achieve clinical efficacy. Nowadays, combined medicine has become a common clinical model particular in TCM hospitals in China.CONCLUSIONS:
It is evident that TCM can provide some assistance in emergency although to combine them in practice is still its infant form and is mainly at TCM hospitals in China. The future effort could be put into TCM research, both in laboratories and clinics, with high quality designs, so that TCM could be better understood and then applied in emergency medicine.KEY WORDS: Traditional Chinese Medicine, Emergency medicine 相似文献12.
The combination of Traditional Chinese Medicine and Interventional Radiology has an excellent clinical effect. This paper reviews the principles and methods of the combined application of Traditional Chinese Medicine and Interventional Radiology, aiming to promote the complementary and coordinated development of Traditional Chinese Medicine and Interventional Radiology. 相似文献
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探索并分析临床上常规使用的具有保肾功能的中成药中的部分中药对糖尿病肾病的保护作用。通过大量阅读相关被涉及的中药功效及西医机制的研究文献,从中总结这些中药对糖尿病肾病的保护作用。并证实这些已被应用于保肾中成药中的单味中药对糖尿病肾病保护作用是明确的。这些中药是保肾中成药中起决定以及关键性作用的成分,并且其中医保肾作用及西医对肾脏功能的保护及延缓是毋庸置疑的。 相似文献
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ObjectivePatients with cardiac arrhythmia were more likely to develop stroke than general population. The therapeutic effect of traditional Chinese medicine (TCM) on the risk of stroke in patients with cardiac arrhythmia was unknown. The aim of this study is to investigate the risk of stroke in patients with cardiac arrhythmia receiving TCM.MethodsFrom the one million cohort of the Taiwan’s National Health Insurance Research Database, we identified cohort of cardiac arrhythmia included 2029 patients who received TCM treatment in 2000–2004. The matching methods with propensity score was used to select 2029 appropriate control cohort for comparison. Incident events of stroke were identified during the follow-up period at the end of 2010. Cox proportional hazard model was used to calculate adjusted hazard ratios and 95% confidence intervals of stroke associated with TCM treatment.ResultsDuring the follow-up period, patients with cardiac arrhythmia who underwent TCM treatment (11.4 per 1000 person-years) had a lower incidence of new-onset stroke than those without TCM treatment (17.7 per 1000 person-years), with an HR of 0.62 (95% CI = 0.50–0.78). The association between TCM treatment and decreased new-onset stroke was both significant in women and men. The young patients aged 45–54 years who received TCM had the lowest risk of stroke (HR = 0.48, 95% CI = 0.27–0.87).ConclusionsReceiving TCM treatment was associated with a lower risk of stroke in patients with cardiac arrhythmia. However, this study was limited by lack of information regarding lifestyles, biochemical profiles, the dose of herbal medicine, and acupuncture points used in treatments. 相似文献
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ObjectivePresentation of a case illustrating the benefits of traditional Chinese medicine (TCM) for treatment of Coronavirus disease 2019 (COVID-19) in critically ill patients.Clinical features and outcomeA 58-year-old woman presented with cough, fever, dizziness, chest tightness, polypnea and poor appetite. She was admitted to Guizhou Provincial People’s hospital, and diagnosed with critically ill type of COVID-19 in February 2020. According to the patient's symptoms and signs, the TCM syndrome differentiation was qi deficiency, dampness-stasis and toxin accumulation. Then she received the combined therapy of a modified Chinese herbal formula and Western medicine. During a twelve-day period of treatment, her respiratory distress and appetite quickly improved. Abnormal laboratory indicators were resumed in time and lung lesions in CT scan largely absorbed. No side effects associated with this Chinese herbal formula were found. Before discharge, two consecutive nasopharyngeal swabs were shown to be negative for severe acute respiratory coronavirus 2 (SARS-CoV-2).ConclusionsOur case report suggests that collaborative treatments with traditional Chinese medicine prove beneficial in the management of COVID-19 in critically ill patients. In order to give optimal care for this COVID-19 crisis for the whole world, Chinese medicine practitioners and Western medical doctors should work together in frontline. 相似文献
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《Complementary Therapies in Medicine》2014,22(1):99-106
BackgroundPatients who usually attend Traditional Chinese Medicine (TCM) need to go to western medicine (WM) doctors for antibiotics in Hong Kong. They might have different knowledge, attitude and practice (KAP) with antibiotics from the WM-attenders.ObjectiveThis study compares TCM attenders with the WM-attenders in Hong Kong about their KAP with antibiotics. The comparison could help future campaigns/education on appropriate antibiotic use.Design and settingA questionnaire on KAP with antibiotics was designed after eight focus groups of purposively selected participants. A territory-wide telephone survey then interviewed randomly selected residents who were aged 18 years or above and spoke the local dialect.ResultOf 2471 respondents, 270 and 2092 usually attended TCM and WM, respectively. Majority of both the TCM- and WM-attenders preferred doctors who were judicious in prescribing antibiotics and seldom asked for them. The TCM-attenders were significantly more likely to be female and with lower household income. They were also more likely to agree that antibiotics were not useful for upper respiratory tract infections and that antibiotic resistance was a serious local problem. They were less likely to accept or be treated with antibiotics. The TCM-attenders were also more concerned about the side-effects of antibiotics. However, they were also less likely than the WM-attenders to always finish a full course of antibiotic.ConclusionApart from non-compliance, the TCM-attenders’ KAP with antibiotics favour the appropriate use of antibiotics. 相似文献
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中药药浴护理技术临床应用的文献计量学研究 总被引:1,自引:0,他引:1
目的对中国知识资源总库(CNKI)中药药浴护理文献进行计量学分析,为开展相关研究提供参考。方法以CNKI 2000-2014年中药药浴护理的有关文献为数据源,利用Excel整理,按文献计量学方法进行统计,对中药药浴护理文献数量、年份分布、论文作者情况、研究资金资助情况、中药药浴相关主题词和文献类型等情况进行分析。结果 CNKI中检索到相关文献568篇,中药药浴护理研究热点集中在术后护理、糖尿病足、失眠等方面。结论中医护理操作技术之中药药浴已在临床得到较广泛应用,为了体现其优势,护理工作者应积极开展前瞻性、大样本、多中心的随机对照研究,提供更多的中医证据。 相似文献
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Mark Anthony Ferro Anne Leis Richard Doll Lyren Chiu Michael Chung Maria-Cristina Barroetavena 《Supportive care in cancer》2007,15(8):985-992
Goals of work This study assessed the impact of acculturation on the prevalence of traditional Chinese medicine and other complementary
and alternative medicine (TCM/CAM) use in newly diagnosed Chinese cancer patients. The individual determinants of TCM/CAM
use among patients were also investigated.
Materials and methods A consecutive sample of Chinese cancer patients treated at the British Columbia Cancer Agency was surveyed at admission using
a 15-item questionnaire. Items included TCM/CAM use, sociodemographics, as well as medical and cultural factors. Data were
analyzed using bivariate methods including Pearson’s X
2 test and Student’s t test. As well, multiple logistic regression was used to obtain the final causal model.
Main results Of the 230 respondents, 57% completed the survey in Chinese and 94% were immigrants. The average age was 59. Participants
had a mean disease duration of approximately 2 months and 79% had already received at least one conventional treatment. Overall,
TCM/CAM was used by 47% of respondents. Herbal remedies, vitamins/minerals, and prayer were the most commonly used therapies.
Multivariable analysis showed that prior TCM/CAM use (p < 0.001), having received conventional treatment(s) (p = 0.029), and being less acculturated (p = 0.028) were associated with TCM/CAM use.
Conclusions Prevalence and type of use were found to vary as a function of the degree of acculturation. Health care practitioners would
be well advised to discuss TCM/CAM use with their patients, especially those who are less acculturated to Western society,
since they are the most likely users of TCM/CAM. 相似文献