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21.
1 病例报告 男 ,16岁 .误食毒蕈后出现恶心 ,呕吐伴有腹痛、腹泻 4d,每日大便 4~ 12次 ,为稀水便 ,有心慌、气短、发热 ,在当地医院以“毒蕈中毒”救治 ,症状无缓解 ,为进一步治疗于 2 0 0 0 - 0 8- 31转入我院 .查体 :T37.8℃ ,P110次·min-1 ,R18次·min-1 ,BP14/ 9k Pa.全身皮肤黄染 ,巩膜重度黄染 ,心肺无阳性体征 .腹平坦 ,上腹部有压痛 ,肌紧张及反跳痛 ,肝脾未触及 ,肝区有叩击痛 ,移动性浊音阳性 .入院后患者出现烦躁 ,意识不清 ,心率时快时慢 ,血压不稳定 .肝功 :T- BIL 2 5 4.1μmol· L-1 ,D- BIL 16 9.5 μmol· L-1 … 相似文献
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D A Smith R T Withers M Brinkman R C Tucker B E Chatterton C G Schultz D G Clark 《European journal of clinical nutrition》1999,53(6):434-440
OBJECTIVE: To test the hypothesis that 55-70 y old male longterm exercisers (LE) have higher resting metabolic rates (RMR) than longterm nonexercisers (LNE). DESIGN: A power analysis demonstrated that this cross-sectional study required 12 subjects per group to detect a 10% RMR difference (kJ x kg FFM(-1) x d(-1)) between the LE and LNE (power = 0.8;alpha = 0.05). SUBJECTS: Twelve LE (X +/- s.d.; 63.5+/-3.4 y; 1.75+/-0.06 m; 69.01+/-8.24 kg; 20.4+/-4.9 %BF) and 12 LNE (63.6+/-5.6 y; 1.72+/-0.07 m; 79.44 12.4 kg; 29.6 4.4 %BF) were recruited from advertisements placed in a newspaper and on university and community noticeboards. INTERVENTIONS: Measurements were conducted for: RMR using the Douglas bag technique; body composition via a four compartment model which is based on determination of body density, total body water and bone mineral mass; and aerobic fitness using a submaximal work test on a cycle ergometer. RESULTS: The LE (93.00+/-7.16 kJ x kg(-1) x d(-1)) registered a significantly greater (P = 0.04) RMR than the LNE (84.70+/-11.23 kJ x kg(-1) x d(-1)) when energy expenditure was expressed relative to body mass, but this difference disappeared (P = 0.55) when the data were corrected for the non-zero intercept of the graph of RMR (MJ/d) against body mass. ANCOVA with FFM as the covariate also indicated that the RMR (MJ/d) difference between the groups was not statistically significant (P = 0.28). The adjusted means for the LE and LNE were 6.39 and 6.62 MJ/d, respectively. CONCLUSIONS: There are no RMR (MJ/d) differences between LE and LNE 54-71 y old males when statistical control is exerted for the effect of FFM and the higher value of the former group for RMR normalised to body mass disappears when this ratio is corrected for statistical bias. 相似文献
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Gray DR Namikas EA Sax MJ Brinkman J Cheung A Gordon M Parker AG Welch PH 《Contemporary pharmacy practice》1979,2(3):108-116
The effect of clinical pharmacy services on the quality and economy of health care provided to psychiatric patients at a Veterans Administration outpatient clinic was evaluated. Twenty-one patients were selected from the Day Treatment Center, of these, 19 patients completed the study. In providing health care to these psychiatric patients, the clinical pharmacist used a systemized approach including data gathering, evaluation, plan of action, and follow-up. In addition, medication groups and weekly staff meetings were incorporated into the patient treatment plan. Following a 3-month study period, the impact of clinical pharmacy services was evaluated. The provision of allied health care to psychiatric patients by clinical pharmacists resulted in a decreased incidence and severity of adverse drug effects, fewer drug use problems, a reduction in the total number of drugs prescribed, improved patient drug knowledge, and reduced expenditures for health care without compromising the patient's mental functioning. 相似文献
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Roy W. Beck MD PhD Eileen E. Birch PhD Susan A. Cotter OD Donald F. Everett MA Richard W. Hertle MD Jonathan M. Holmes BM BCh Raymond T. Kraker MSPH Don W. Lyon OD Pamela S. Moke MSPH Graham E. Quinn MD MSCE Michael X. Repka MD Mitchell M. Scheiman OD David K. Wallace MD David R. Weakley Jr MD OD 《American journal of ophthalmology》2004,138(4):698
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K.BM. LEE J.M. LEE† C.Y. PARK K.B. LEE H.Y. CHO‡ & S.Y. HA‡ 《International journal of gynecological cancer》2006,16(4):1569-1573
The objective of this study was to investigate the efficacy of treatment strategies in patients with adenocarcinoma (AC) of the cervix and compare it with those with squamous cell carcinoma (SCC) of the cervix. Women with FIGO (1994) stage IB1 AC, especially pathologic tumor size of 2-4 cm, treated with class III hysterectomy, were compared with those with SCC treated with comparable strategy in a case-controlled study. Eighty patients (20 cases, 60 controls) were analyzed. Lymphvascular space invasion (P = 0.01) and lymph node metastasis (P = 0.07) were more frequent in patients with SCC than in those with AC. However, there was no significant difference in depth of stromal invasion (P = 0.51) and invasion of the parametrium (P = 0.44) between two groups. And there was also no statistically significant difference in disease-free survival (P = 0.86) and overall survival (P = 0.89) between two groups. Primary radical surgery followed by adjuvant therapy, same as for SCC, would be acceptable for AC with pathologic tumor size of 2-4 cm. Although it was difficult to determine whether AC recurred more systemically, more effective treatment strategies than those currently available for AC should be considered to reduce the systemic recurrence. 相似文献
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Tear of the distal biceps brachii tendon is an uncommon injury. Ultrasound evaluation of the distal tendon using an anterior approach is often difficult because of technical factors. We describe a new method of ultrasound evaluation of the distal biceps tendon insertion. This involves a posterior approach with the forearm pronated. With pronation of the forearm, the radial tuberosity faces posteriorly, bringing the distal biceps tendon insertion into view. A surgically proven case of distal biceps tendon tear is presented to illustrate our technique. 相似文献
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Fluoroquinolone antibiotic therapy is a recognized but poorly understood cause for Achilles tendinopathy. We report here a patient who developed bilateral partial Achilles tendon tears as a result of fluoroquinolone therapy. Ultrasound and MRI were both useful in identifying and distinguishing between Achilles tendinosis and tendon rupture. The current published literature on this problem was also reviewed. 相似文献
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