Free‐wall perforation of the left ventricle after acute myocardial infarction complicated with pericardial tamponade that mimicked ascending aortic dissection: A case report

Life‐threatening cardiac events may be misdiagnosed as acute aortic dissection because of notable symptom mimicry. We report the case of a 72‐year‐old male patient with presentations presumed to be of aortic origin. However, surgery revealed posterior free‐wall perforation in the left ventricle caused by the occlusion of an obtuse marginal branch.     

Follicular dendritic cell sarcoma of the nasopharynx: a case report and literature review

Follicular dendritic cell sarcoma (FDCS) of the nasopharynx is a rare malignant tumor that has been described in only a few case reports, and its differential diagnoses include diverse clinicopathologic entities. FDCS is often initially misdiagnosed, especially when examining small biopsy specimens. We herein report a case of FDCS arising in the nasopharynx that was initially misdiagnosed as a nerve sheath tumor. A 44-year-old woman presented with persistent obstruction of the left nasal cavity and underwent an excisional biopsy. The specimen demonstrated morphologic and immunohistochemical features of FDCS. In situ hybridization for Epstein–Barr virus-encoded RNA was negative. The patient was treated with chemotherapy and radiotherapy. The sarcoma recurred near the original site more than 3 years after the initial treatment and was completely resected. At the time of this writing, the patient had remained disease-free for 1 year after resection. This case is being reported to improve the clinical recognition of FDCS.     

中西医结合论治不孕不育症

男女双方同居1年以上,性生活正常未受孕者称为不孕症;能受孕但因多种原因导致流产者称为不育症。不孕不育症是临床常见病,将排卵障碍性不孕、输卵管性不孕、盆腔生殖器官炎症性不孕、免疫性不孕不育、子宫性不孕不育5种类型的中、西医病因病机及实际临床中的治疗方法进行总结,并举3例典型病案进行讨论分析。     

运用五运六气学说辨治便血验案1则

通过分析肠风下血验案,阐述运气学说在临证中的重要性。认为对于肠风的辨治,可根据其运气特征,"岁金不及,从肺论治";运用整体思维,病在下者取之上,清肝以肃肺,养血而止血,予槐角丸、黛蛤散、胶艾汤治疗。     

浅析绮石论虚劳之"先天之因"

综考历代相关文献,虚劳之先天成因有以下几个方面:一是早婚早育,肌体稚弱,精气未生,血气未充,肾元亏虚;二是久病、劳逸过度、性生活失调导致父母体质虚弱;三是高龄生育;四是妊娠失养导致子代先天禀赋薄弱,胎儿气血供养不足,出生后体质虚弱,生长发育受到影响,从而形成虚劳的病理基础。     

Solid lipid nanoparticles for ocular drug delivery

Ocular drug delivery remains challenging because of the complex nature and structure of the eye. Conventional systems, such as eye drops and ointments, are inefficient, whereas systemic administration requires high doses resulting in significant toxicity. There is a need to develop novel drug delivery carriers capable of increasing ocular bioavailability and decreasing both local and systemic cytotoxicity. Nanotechnology is expected to revolutionize ocular drug delivery. Many nano-structured systems have been employed for ocular drug delivery and yielded some promising results. Solid lipid nanoparticles (SLNs) have been looked at as a potential drug carrier system since the 1990s. SLNs do not show biotoxicity as they are prepared from physiological lipids. SLNs are especially useful in ocular drug delivery as they can enhance the corneal absorption of drugs and improve the ocular bioavailability of both hydrophilic and lipophilic drugs. SLNs have another advantage of allowing autoclave sterilization, a necessary step towards formulation of ocular preparations. This review outlines in detail the various production, characterization, sterilization, and stabilization techniques for SLNs. In-vitro and in-vivo methods to study the drug release profile of SLNs have been explained. Special attention has been given to the nature of lipids and surfactants commonly used for SLN production. A summary of previous studies involving the use of SLNs in ocular drug delivery is provided, along with a critical evaluation of SLNs as a potential ocular delivery system.     

儿童痢疾型Reiter综合征一例报告

Reiter综合征是以关节炎、尿道炎和结膜炎三联征为临床特征的一种特殊类型的反应性关节炎。根据前 驱感染的不同分为性传播型和痢疾型。该病儿童少见,临床医生认识不足,易误诊、漏诊。本文回顾性分析总结了1 例20个月的女童感染细菌性痢疾后导致Reiter综合征的发病特点、临床表现、治疗及转归,以提高对本病的认识。     

从五脏整体观辨证论治复发性口腔溃疡验案1则

复发性口腔溃疡(Recurrent oral ulcer,ROU)是以口腔黏膜出现孤立的圆形或椭圆形浅表溃疡,表现为烧灼样疼痛并且反复发作为特征的一类疾病。本病患者病情日久不愈,迁延多年,发作时疼痛难耐,严重影响生活质量。中医学基于五脏整体观的经典理论,在临床诊治中发挥整体辨治的优势,对于复发性口腔溃疡的缓解和愈后具有良好的临床效果。     

刘凤斌教授治疗慢性萎缩性胃炎的病例系列挖掘分析和经验总结

为总结刘凤斌教授中医药治疗慢性萎缩性胃炎的理论思想和临床经验,采用回顾性病例系列研究和专家访谈结合设计,首先回顾2009—2013年在广州中医药大学第一附属医院就诊的慢性萎缩性胃炎患者资料,提取所用中药、疾病、证型、医疗费用和药物数量等信息,数据整理后采用统计描述和二分类Logistic回归分析确定证型和初步的主药及加减变化,统计时同时进行全集和亚组分析;然后进行专家访谈讨论形成最终的证型及用药。结果共收集到228例慢性萎缩性胃炎患者资料,年龄(50.30±10.18)岁,男性151例(66.23%),女性77例(33.77%)。157例患者提取到中医诊断和证型信息,其中胃痞和胃脘痛各115和23例,缺失19例,包含脾胃虚弱证、脾虚湿热证、脾胃不和证、肝郁脾虚证、肝胃不和证、气阴不足证患者12,57,18,23,21,26例。整体228例患者共用104味中药,亚组157例患者共用94味中药,总结各组前15味中药形成初步的治疗主药和加减变化。然后,使用亚组157例患者资料,以各证型为因变量,纳入前32味中药进行Logistic回归分析,形成各证型下的加减用药变化。专家评阅修改后认为病因与饮食、情绪、体虚有关,病机是"脾虚气滞,热郁络瘀",并确定以上6种证型和12味治疗主药,包括太子参、茯苓、白术、甘草、浙贝母、海螵蛸、大腹皮、枳壳、紫苏梗、白花蛇舌草、半枝莲、醋莪术。该研究基于临床实践数据和专家访谈信息总结了刘凤斌教授中医药治疗慢性萎缩性胃炎的思想经验,设计严谨,具有良好的科学性和实用性。     

功能锻炼配合青鹏膏外用治疗轻度肩关节周围炎随机对照研究

目的：观察功能锻炼配合青鹏膏外用治疗轻度肩关节周围炎的疗效。方法：将200例轻度肩周炎患者,随机分为功能锻炼配合青鹏膏外用治疗组和单纯功能锻炼对照组各100例。治疗组在局部外用青鹏膏后,进行双手爬墙、挽背健手拉患手及前屈患手摸对侧耳朵锻炼,2次/d,每次以上3个锻炼动作各作10次,30d为1个疗程。对照组单纯进行锻炼,疗程同治疗组。采用肩关节周围炎疗效评定量表观察治疗前后2组患者的肩关节疼痛评分、肩关节日常活动评分及日常生活能力评分。结果：2组患者肩关节疼痛评分、肩关节活功能评分及日常生活能力评分治疗后均较治疗前提高,差异均有统计学意义（治疗组P〈0.01,对照组P〈0.05）,治疗后组间比较,治疗组较对照组提高更明显,差异亦具有统计学意义（肩关节疼痛评分P〈0.01,肩关节活动功能及日常生活能力评分P〈0.05）。结论：功能锻炼配合青鹏膏外用治疗轻度肩关节周围炎疗效显著。