四肢无力3月余 视物成双2 个月 尿急1 个月简

病历摘要 患者女性,55岁。因四肢无力3月余、视物成双2个月,加重伴尿急1个月,于2013年10月31日入院。患者入院前3个月（2013年7月中旬）出现双下肢肌力减弱、行走易疲劳,尤以上台阶费力,但下蹲后可自行站起,晨起、休息后症状缓解,晚间或活动后症状加重;约2周后（2013年7月底）出现双上肢肌力减弱,抬手臂或梳头无力,能持握碗筷,不伴肢体麻木、肌柬颤等,至当地医院就诊。     

建构主义理论结合网络平台在"感染病学"临床教学中的应用

是临床医学重要课程之一, 带教老师时间少、学生学习目标不明确、兴“感染病学”当前的临床教学存在临床教学时间短、趣缺乏等问题。本研究就建构主义理论结合网络平台引入该课程临床教学中的必要性、优势及实施方式作一探讨,以期为“感染病学”的临床教学改进提供参考。     

Thymoquinone (2-Isopropyl-5-methyl-1, 4-benzoquinone) as a chemopreventive/anticancer agent: Chemistry and biological effects

Cancer remains the topmost disorder of the mankind and number of cases is unceasingly growing at unprecedented rates. Although the synthetic anti-cancer compounds still hold the largest market in the modern treatment of cancer, natural agents have always been tried and tested for potential anti-cancer properties. Thymoquinone (TQ), a monoterpene and main ingredient in the essential oil of Nigella sativa L. has got very eminent rankings in the traditional systems of medicine for its anti-cancer pharmacological properties. In this review we summarized the diverse aspects of TQ including its chemistry, biosynthesis, sources and pharmacological properties with a major concern being attributed to its anti-cancer efficacies. The role of TQ in different aspects involved in the pathogenesis of cancer like inflammation, angiogenesis, apoptosis, cell cycle regulation, proliferation, invasion and migration have been described. The mechanism of action of TQ in different cancer types has been briefly accounted. Other safety and toxicological aspects and some combination therapies involving TQ have also been touched. A detailed literature search was carried out using various online search engines like google scholar and pubmed regarding the available research and review accounts on thymoquinone upto may 2019. All the articles reporting significant addition to the activities of thymoquinone were selected. Additional information was acquired from ethno botanical literature focusing on thymoquinone. The compound has been the centre of attention for a long time period and researched regularly in quite considerable numbers for its various physicochemical, medicinal, biological and pharmacological perspectives. Thymoquinone is studied for various chemical and pharmacological activities and demonstrated promising anti-cancer potential. The reviewed reports confirmed the strong anti-cancer efficacy of thymoquinone. Further in-vitro and in-vivo research is strongly warranted regarding the complete exploration of thymoquinone in ethnopharmacological context.     

The need for a paradigm shift in adherence research: The case of ADHD

Nonadherence to long-term medications attenuates optimum health outcomes. There is an abundance of research on measuring and identifying factors affecting medication adherence in a range of chronic medical conditions. However, there is a lack of standardisation in adherence research, namely in the methods and measures used. In the case of attention deficit hyperactivity disorder, this lack of standardisation makes it difficult to compare and combine findings and to draw meaningful conclusions. Standardisation should commence with a universally accepted categorisation or taxonomy of adherence which takes into consideration the dynamic nature of medication-taking. This should then be followed by the use of valid and reliable measures of adherence which can accurately quantify adherence at any of its phases, and provide useful information which can be utilised in planning targeted interventions to improve adherence throughout the patient medication-taking journey.     

Hydroxyapatite nanorods loaded with parathyroid hormone (PTH) synergistically enhance the net formative effect of PTH anabolic therapy

Parathyroid hormone (PTH) has been a major contributor to the anabolic therapy for osteoporosis, but its delivery to bone without losing activity and avoiding adverse local effects remain a challenge. Being the natural component of bone, use of hydroxyapatite for this purpose brings a major breakthrough in synergistic anabolism. This study focuses on synthesis, characterization and evaluation of in vitro and in vivo efficacy of PTH (1-34) adsorbed hydroxyapatite nanocarrier for synergistic enhancement in the anabolic activity of PTH for bone regeneration. The negative zeta potential of this nanocarrier facilitated its affinity to the Ca²⁺ rich bone tissue and solubilization at low pH enhanced specific delivery of PTH to the resorption pits in osteoporotic bone. In this process, PTH retained its anabolic effect and at the same time an increase in bone mineral content indicated enhancement of the net formative effect of the PTH anabolic therapy.     

Burden of asthma among children in a developing megacity: childhood asthma study,Pakistan

Objectives: Global burden of childhood asthma has increased in the past few decades, particularly in low-income countries. In Pakistan, there is a lack of community-based epidemiological studies estimating the burden of asthma among children. This study determined the prevalence and predictors of asthma among children 3–17 years of age in Karachi, Pakistan. Methods: A two-stage community-based representative cross-sectional survey was conducted in Karachi from March 2012 to April 2013 comprising 1046 children aged 3–17 years. Of 7500 clusters, 80 were randomly selected, and of these, 15 children per cluster were enrolled randomly. A translated and pre-tested version of International Study of Asthma and Allergies in Children questionnaire was administered. Results: The overall prevalence of asthma among study participants was 10.2% (95% CI: 8.4–12.0). Asthma was more likely to occur among boys (adj. OR: 2.5, 95% CI: 1.6–4.0), children in the younger age group (3–7 years) (adj. OR: 2.9, 95% CI: 1.7–4.8), those living in households with ill-ventilated kitchens (adj. OR: 1.8, 95% CI: 1.1–3.1), having family history of asthma (adj. OR: 2.3, 95% CI: 1.3–3.9) and those of the Sindhi ethnicity (adj. OR: 2.2, 95% CI: 1.1–4.4). Conclusion: This study is the first robust evidence regarding asthma among children in Pakistan, reporting a high burden in this group. Family history, male gender, Sindhi ethnicity and ill-ventilated kitchen were identified as important predictors of asthma. Targeted preventive measures and intervention studies are required to better understand and reduce the burden of asthma among children in Pakistan.     

以下肢深静脉血栓为首发症状的恶性肿瘤患者28例临床分析

【摘要】　目的?分析以下肢深静脉血栓（DVT）为首发症状的恶性肿瘤患者的临床特点,探讨下肢DVT与肿瘤关系。方法?回顾性分析2013年5月至2018年5月收治的342例特发性（无明显诱因）DVT患者的临床资料。结果?住院及随诊期间诊断恶性肿瘤患者28例,占新诊断特发性DVT患者8.2%。结论?特发性DVT患者,尤其是多发血栓、溶栓效果欠佳伴凝血功能异常的患者应高度警惕恶性肿瘤的发生。