简介：ＰＡＴＩＥＮＴＭＯＮＩＴＯＲＩＮＧＳＹＳＴＥＭＰＡＴＩＥＮＴＭＯＮＩＴＯＲＩＮＧＳＹＳＴＥＭＨａｕＧｕｉｆｅｎ；ＬｉｕＧｕａｎｇｒｏｎｇ（ＣｈｉｎｅｓｅＰＬＡ．ＧｅｎｅｒａｌＨｏｓｐｉｔａｌ１００８５３，Ｂｅｉｊｉｎｇ，Ｃｈｉｎａ）ＳｕｃｈａｓＰａｔ...

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简介：Clinicaldecision-makingiswhatallcardiovascularphysiciansdo.Thepurposeofdecision-makingistomakethediagnosis,decideonappropriatetherapyandestimatetheprognosisoftheindividualpatient.Regardingtheprognosis,populationprognosticdataisusedbutthismayormaynotapplytotheindividualpatient.LVfunction,nomatterhowitisdeterminedseemstocorrelatebestwithprognosis.Butweneedtorememberthatprognosticationoftheindividualis,atbest,aneducatedguess.

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简介：Objective:Toevaluatetheauditoryfunctionofanindividualwithgeneticallyconfirmedhemochromatosis.Methods:A57yearoldmalewithmildlyimpairedsounddetectionthresholdsunderwentarangeofbehavioural,electroacousticandelectrophysiologicassessments.Theseincludedtherecordingofotoacousticemissionsandauditorybrainstemresponses,measurementofmonauraltemporalresolutionandevaluationofbinauralspeechprocessing.Findingsforthispatientweresubsequentlycomparedwiththoseof80healthycontrolswithsimilaraudiometricthresholds.Results:Thepatientshowedthethreecardinalfeaturesofauditoryneuropathy,presentingwithevidenceofnormalcochlearouterhaircellfunction,disruptedneuralactivityintheauditorynerve/brainstemandimpairedtemporalprocessing.Hisfunctionalhearingability(speechperception)wassignificantlyaffectedandsuggestedareducedcapacitytouselocalizationcuestosegregatesignalsinthepresenceofbackgroundnoise.Conclusion:Wepresentthefirstcaseofanindividualwithhemochromatosisandauditoryneuropathy.Thefindingsforthispatienthighlighttheneedforcarefulevaluationofauditoryfunctioninindividualswiththedisorder.

简介：Inprimarymitralregurgitationthereareanatomicabnormalitiesofthemitralvalvecausingbackwardflow,placingahemodynamicburdenontheleftventricle.Ifthisburdenissevereandprolonged,itleadstoleftventriculardamage,heartfailure,anddeath.Thepreferredtherapyisrestorationofmitralcompetencethroughmitralvalverepair,whichissaferthanmitralvalvereplacement.Whenrepairisperformedinatimelyfashion,lifespancanbereturnedtothatofanormalindividual.Triggersfortimelyrepairincludetheonsetofsymptomsandevidenceofleftventriculardysfunctionasdeterminedbyejectionfractionfallingtoward60%and/orend-systolicdimensionincreasingtoward40mm.

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简介：瞄准：有希望地在年轻病人学习发生和尖锐憩室炎的自然科学。方法：与尖锐憩室炎的诊断在我们在2000年1月之间的医院就医到2005年2月的207个病人的一个总数被包括。他们的人口统计的特征，病历，physical，X光线照相术、内视镜的调查结果以及治疗被记录。病人们被跟随为第一年的每6瞬间并且以后每年。结果：吝啬的病人的年龄是61(范围27-92)年。25个病人(12%)比45年年轻。尖锐憩室炎是显著地，在在年轻年龄组的男性之中流行的更多作为与老年相比组织(19/25，76%对61/182，33%，分别地P=0.0001)。复杂并发症更经常发生在年轻年龄组；32%对13%，(P=0.002)。在后续期间，6个病人(28%)在老年组作为与87个病人(55%)相比在年轻年龄组仍然保持无征状(P=0.024)。作为结果，sigmoidectomies是被执行两次经常在年轻年龄组(38%对13%，P=0.002)。结论：在年轻病人的憩室炎有男优势，有复杂并发症和更高的再发率的更高的率的一堂更好攻击的功课。一条更早外科的途径可能与尖锐憩室炎在年轻病人被考虑。

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简介：AbstractParotidectomy is the mainstay treatment for tumors of the parotid gland. In an effort to improve clinical outcomes, several modern surgical techniques and perioperative interventions have been evaluated and refined. This review discusses current and actively debated perioperative interventions aimed at improving patient safety and the quality of parotidectomy. Relevant high-impact literature pertaining to preoperative diagnostic modalities, intraoperative surgical techniques, and postoperative care will be described.

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简介：Theearlydiagnosisofcardiacruptureisoneofthekeyfactorsforasuccessfuloutcome.However,theaccuratediagnosisisoftendifficultintheearlystageofinjury,especiallywhensomeobviousseverewoundsarefoundinotherregionsofthebody,1,2fortheyareeasytodisguisethesymptomoftheheart.Wereportacasewithcardiacruptureandlivertraumacausedbytrafficaccident.

简介：Managementofrheumaticmitralregurgitationinawomancontemplatingpregnancypresentsuniquechallengesfortheclinician.Whentaskedwithtakingcareofthistypeofpatient,attentionneedstobepaidtothepatient’sfunctionalstatustodetermineifsymptomsarepresent.Inadditiontothisclinicalassessment,transthoracicechocardiographyisalsocritical.Itprovidesinsightintotheetiologyofthemitralregurgitation,assessesforthepresenceofconcomitantmitralstenosisorothervalvularabnormalities,characterizestheseverityofmitralregurgitationthroughanintegrativeapproachandidentifieshighriskfindingsincludingprogressiveleftventricular(LV)dilationandLVdysfunction.SurgicalinterventionisrecommendedforsymptomaticpatientsandinasymptomaticpatientswithevidenceofprogressiveLVdilationandaLVejectionfractionoflessthan60%.Whilethepresenceofpulmonaryhypertensionandatrialfibrillationhavebeenshowntoberiskfactorsindegenerativemitralregurgitation,thesamehasnotbeendemonstratedinrheumaticmitralvalvedisease.Whilemitralregurgitationmaybereasonablywelltoleratedduringpregnancy,symptomaticpatientsareathigherriskforadversematernalandfetaloutcomes,andtherefore,itisrecommendedthatmitralvalvesurgerybeperformedpriortopregnancy.Oncethedecisionhasbeenmadetoproceedtosurgery,mitralrepair,performedataHeartValveCenterofExcellenceisrecommendedifpossibleduetoimprovedoutcomes.Mitralvalverepairispossiblein>80%casesofrheumaticmitralregurgitation.Ifrepairisnotpossible,replacementwitheitherabioprostheticormechanicalvalvearereasonableoptions.Thereareadvantagesanddisadvantagestoeachapproachandthechoiceofprosthesisshouldbeashareddecisionbetweenthepatientandhertreatmentteam.

简介：Purposes:Wereportedtherolesandfunctionsofnursesinhomevisitsforbraintumorpatientsusingthefamilyhealthassessmentguideinthestudy.Methods:Onepatientofbraingliomawaschosenasthecaseillustration.Thenursesassessedthepatients’situation,theirfamiliesandlivingenvironmentindividually.Allthesefactorswereanalyzedtogether.Results:Thenursesthenimplementedtheirknowledgeandskillstoadoptdifferentmeasuresindifferentconditions,investigatedthepatients’healthproblemsandcarriedoutpersonalizedeffectiveactions.Conclusions:Nursesshouldputeffortintocommunitynursingtoallowpatientstoliveinasafeenvironment,tosatisfythehealthneedsofhumanbeingandtheirneedsforhealthknowledge,andenhancetheirself-careabilities.

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简介：<正>DearSir,IamJinAChoi,fromtheDepartmentofOphthalmologyofSt.VincentHospitalofSuwon,Kyungki-do,SouthKorea.IwritetopresentacasereportofayoungfemaletreatedwiththediagnosisofPosner-Schlossmansyndromeforseveralyears,inwhichshewasultimatelyprovedtohaveiridocornealendothelial(ICE)syndrome.Posner-Schlossmansyndrome(PSsyndrome)ischaracterizedbyrecurrentattacksofmildanterioruveitiswithmarkedelevationofintraocularpressure(IOP)[1].Theexactetiologyofthissyndromeisnotfullyestablishedyet.However,thepossibleroleofherpessimplexvirus(HSV)issuggestedbyastudythatrevealedDNAevidenceofthevirusinallaqueousspecimensofpatientsduringacuteattacksinPSsyndrome[1,2].ICEisaspectrumofdiseasethat

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简介：如果需要用最简短的语言来总结《英国病人》的主题,那就应该是"战争与爱情"。1944年的夏日,在意大利一所废弃的乡间别墅,战争将来自加拿大的女护士哈娜、她的父辈好友卡拉瓦焦、印度籍排雷士兵基普以及被人们称为"英国病人"的无名伤者带到了一

简介：Lungcancerisacommonmalignanttumor,whichhasahighincidenceandmortalityrate.Therefore,itisnecessarytoseekanewmethodforthediagnosis,especiallytheearlydiagnosisoflungcancer.Thedevelopmentofmolecularbiologymakesthegenediagnosisoflungcancerpossible.PCR-SSCP...

简介：A70-year-oldmanisseenforevaluationofaheartmurmurheardbyhisprimarycareprovider.Thepatientplaysdoublestennistwiceperweekandclaimstobeasymptomatic.–Medication:amlodipineforhypertension.–Physicalexamination(PE):pulse82bpm;bloodpressure140/90mmHg.–Neck:neckveinsflat.Carotidsdelayed.–Chest:clear.–Cardiovascular:grade2/6latepeakingsystolicejectionmurmur.–Extremities:normalpulses.–Echocardiogram:heavilycalcifiedaorticvalve.Peakjetvelocity4.6m/s.Aorticvalvearea0.7cm2.Rightventricularsystolicpressurenotobtainable.