m*********k
发帖数: 10521 | 1 "[NewYork]Vesper8 Jul 3. ● 发包子预祝大家国庆节快乐！"
成功奖励 10 伪币的用户: tomm29, jkz737, newyorkt, NYKnicks, iamapig, awq,
TOTAL616, FakeMask, nancyzhk, zhiwei, usajjww, szxiami, yling, poiuytre,
Otaku08820, nystar, proper, EveryLT, BlackQueen, merryleecp, auo, honyi,
blueDVD, lulushz, Rohto, LXJSmonk, happy22, zhubaba, violetlily9, jaff1973,
BobJackson, plus, jerseyboy, opt, CRP, yanma, jaye, joymom, goodboy, misty,
lynn2007, duoduofan, xatu, uspeng, ChinaGirl, green2900, YellowLeaf,
southnorth, HAOBAOBA... 阅读全帖 |
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m*********k
发帖数: 10521 | 2 "[Joke]Matisse Aug 30 ● 各位长周末快乐，发300个上任包。"
成功奖励 10 伪币的用户: kjbl, clonebar, ppfc, gaea, zeami, zpko123, neun,
JPEG, kejer, biokold, bankbuster, mahjong, tuzinewyork, chaosbeaver, yccyccy
, opamp741, isomer, Huangchong, bleakhand, lpec, Gotze, locarno, jianke,
lulushz, tinybug, xiaopo, sunzhq04, myfault, jimsimons, givemeoffer, fans,
mttbbs, monthly, MidStudent, RAY2008, Huan2007, shern, xiongmaoren, Pasacat,
GGYY, elvinGG, xmj75, archbass, FranklinDou, chairsky, moonriver, njutruly,
foxzeng,... 阅读全帖 |
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m*********k
发帖数: 10521 | 3 "[NewYork]Vesper8 Sep 30 ● 发国庆节包子！"
成功奖励 10 伪币的用户: jkz737, redyellowblu, minmeng, heartincn, wakinchau,
VikingGundam, shangxi, janekk11, MKZ, plus, EveryLT, haixin, nystar, honyi,
HL, Milstein, fatmingzhou, goodboy, usajjww, betaking, uspeng, avani,
Original, poiuytre, piggywong, rtfm, TianGe, NYKnicks, PNH689, majia55,
liiil, lulushz, meiyouruguo, auo, bwqxmm, Sunshinemm, antena, bowdy, iamapig
, soloscar, mxf, CNES, zhubaba, FakeMask, opt, Rohto, acsca, Chyromancer,
facedown, daxue, pand... 阅读全帖 |
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r***l
发帖数: 163 | 4 有国内朋友想做进口体外诊断试剂盒，特别对下列免疫比浊项目有兴趣。不知道版上有
没有做这块可以合作的朋友？或许能指点下去哪里找这样的合作伙伴比较靠谱，不胜感
激！
如果供应商在中国没有代理，可以帮他们在中国跑审批做代理。如果已经有代理，是不
是还能帮他们在不同地区销售或者代理？还请有经验的高手指点一二。另外，请教下怎
么查这些试剂盒的价格，多谢！
免疫比浊项目
1． PGⅠ 胃蛋白酶原Ⅰ
2． PGⅡ 胃蛋白酶原Ⅱ
3． HP 胃幽门螺旋杆菌
4． RbP 视黄醇结合蛋白
5． NGAL 人类中性粒细胞明胶酶相关载脂蛋白
6． CystatinC 胱氨酸蛋白酶抑制剂 C
7． Myo 肌红蛋白Myoglobin
8． TnI / TnT 肌钙蛋白Ultra Troponin
9． HFABP 心肌型脂肪酸结合蛋白
10． Hcy 同型半胱氨酸
11． NT-proBNP 脑钠肽
12．... 阅读全帖 |
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A*******s
发帖数: 9638 | 5 The reasons i believe she has conversion are:
1. Inconsistency on physical exam. For example, she was paraplegic but at the
exam, she was able to stand up with assistance.
2. Normal MRI of brain and whole spine.
3. Normal LP.
4. Normal NCV/EMG.
5. Normal ESR, CRP, and CPK.
6. After the reassurance, she had a dramatic improvement.
Why she used a cane? I think she was still seeking medical attention or
reassurance. Maybe the psychiatrists can provide a better explanation.
查体，问：“这痛吗”， 答：痛。教授又查... 阅读全帖 |
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A*******s
发帖数: 9638 | 6 昨天有同仁对我的一个case感兴趣， 我今天查了下病历， 给大家写个完整的。
53 yrs old WM, previously healthy, presented with intractable fatigue and
weight loss for 3 months. A comprehensive workup by his PCP including a CT
of chest was reported as unremarkable.
PMH: Asthma, seeing a pulmonologist who reviewed chest CT and agreed with
radiologist's report.
Soical. Smoker 1 ppd. No ETOH/Drug.
FMH: neg for CA.
ROS: Not remarkable, no diplopia, dysphagia, no fever, no joint pain, no
muscle ache.
PE: Vital normal.
No positive finding... 阅读全帖 |
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A*******s
发帖数: 9638 | 7 昨天有同仁对我的一个case感兴趣， 我今天查了下病历， 给大家写个完整的。
53 yrs old WM, previously healthy, presented with intractable fatigue and
weight loss for 3 months. A comprehensive workup by his PCP including a CT
of chest was reported as unremarkable.
PMH: Asthma, seeing a pulmonologist who reviewed chest CT and agreed with
radiologist's report.
Soical. Smoker 1 ppd. No ETOH/Drug.
FMH: neg for CA.
ROS: Not remarkable, no diplopia, dysphagia, no fever, no joint pain, no
muscle ache.
PE: Vital normal.
No positive finding... 阅读全帖 |
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l*****l
发帖数: 47 | 8 是2010年改的guideline，很多培训中心都是4月份才更新的。除了改为CAB以为，按压
的速度和深度也增加了。
P.S 我跟楼主一样，老是把CPR说成了CRP了。 |
|
l*****l
发帖数: 47 | 9 是2010年改的guideline，很多培训中心都是4月份才更新的。除了改为CAB以为，按压
的速度和深度也增加了。
P.S 我跟楼主一样，老是把CPR说成了CRP了。 |
|
A*******s
发帖数: 9638 | 10 84 yrs old WF, presented with right eye vision loss for the past 10 days.
Her left eye went blind 1 year ago. She was seen by an optometrist who
diagnosed her as GCA. Her daughter brought her to me for a 2nd opinion.
PMH: Left eye blindness for 1 year. DM. HTN and CRF.
On exam: Temporal tenderness bilaterally. VA: 20/70 OD, 20/400 OS. (+)APD.
fundoscopy suggests ischemic changes, no papillary edema.
Lab: ESR 20; CRP: 0.6.
What are you going to tell the daughter? |
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A*******s
发帖数: 9638 | 11 You are right about ESR/CRP.
She was seen by an ophthalmologist who suggested GCA as well.
Neither of them suggested macular degeneration or DM retinalopathy.
MS is less likely due to her age.
So do you think she needs a biopsy? |
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A*******s
发帖数: 9638 | 12 What if she has no GCA since ESR/CRP are normal? |
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A*******s
发帖数: 9638 | 13 http://www.eyeassociates.com/understanding_a_stroke_of_the_op.h
Since ESR/CRP is normal, she likely has Non-Arteritic” Anterior Ischemic
Optic Neuropathy (NAAION). The risk factor is DM.
Final diagnosis depends on temporal artery biopsy.
Two possibilties:
1.Patient has GCA(less likely), she needs long term steroids which is no
good for her DM.
2.AION not related to GCA (more likely), no treatment except ASA.
After a long discussion, the patient and the family decided to leave it
alone and take ... 阅读全帖 |
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y***d
发帖数: 33 | 14 Came too late. I'll toss in my 2 cents anyways. Like a good Monday morning
quarterback, I would put some question marks on GCA after seeing the normal
ESR/CRP, especially if the patient has no other inflammatory symptoms such
as fatigue, stiffnedd, weakness, headache, etc.
Never heard of NAAION before. If I were to see this patient in clinic,
probably would have sent him straight to ophtho's office or ER and let the
experts figure it out.
Learned one more thing today. Thanks. |
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A*******s
发帖数: 9638 | 15 I noticed there are some changes. Thanks for the updates.
For a case like that, you have to make sure if the patient has true weakness
. In some cases, the patient could not walk or feel weak just because of
PAIN. I haven't noticed you mentioned the pain which I believe she has.
I would check ERS/CRP and CK, a lot of cases like that, especially an aged
woman, could have PMR.
DM amyotrophy is another DDx if PMR can be R/O.
With both sensory/motor involvement on a single leg, radiculopathy is mo... 阅读全帖 |
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y******a
发帖数: 590 | 16 how about other inflammatory markers, e.g. CRP, ESR, albumin, platelet, LDH?
are they also elevated? |
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r*******n
发帖数: 51 | 17 I am not sure whether CRP, ESR and LDH were ordered or not. Below are all
tests that were ordered and normal.
Albumin and platelet are normal.
Besides, Creatinine, Creatinine(Crcl), Estimated Glomerular Filteration Rate
- MDRD, Bilirubin Total, Alkaline Phosphatase, and Gama Glutamyl
Transferase are normal.
Iron, Iron saturation, B12, TSH, A1C, eGFR, Cholesterol, Triglycerides, HDL,
LDL, TC/HDL-C Ratio, and Potassium are normal.
Hemoglobin, Hematocrit, RBC, RBC indeces: MCV, MCH, MCHC, RDW, WBC,... 阅读全帖 |
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y******a
发帖数: 590 | 18 No I don't think you need to check those. As fionaww mentioned earlier,
ferritin is also a marker for chronic inflammation. But with chronic
inflammation, you will see other abnormalities, like anemia, low albumin, high
platelet count, high ESR, CRP, and LDH. With a normal albumin and PLT, it's
unlikely you have chronic inflammation going on. |
|
y******a
发帖数: 590 | 19 I am not convinced that he has immune deficiency. Based on all your posts,
he has not had any positive cultures anywhere. Hypogammaglobulinemia can be
caused by reduced hepatic synthesis, like in patients with cirrhosis. I am
not impressed by hypocomplementia either, for the same reason.
Go back to his history, he has had recurrent fevers for years. Has he ever
had any episode that he did use antibiotics and fever resolved by itself in
a few days? Do his fever episodes follow any patterns? ... 阅读全帖 |
|
B****r
发帖数: 1737 | 20 看了三次医生，没有任何进展。可能下周要收入院了。小地方没有儿童医院，也不知道
该不该换个别的医生。恳请大家帮着瞧瞧 （病人情况如下）。万分感谢。
5 yo female with persistent cough x 14 days and fever x 10 days. Fever runs
102-104 F, but does normalize when given motrin or tylenol. Symptom no
improvement after 4 days of Azithromycin. Began to have loose stool /watery
diarrhea for past 3-4 days. She had complained of abdominal pain (mostly
peri-umbilical) intermittently for the past 2-3 weeks. Has a history of
problems with constipation. Slightly decreased PO intake, ... 阅读全帖 |
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m******r
发帖数: 1904 | 21 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: Blazer (--), 信区: MedicalCareer
标 题: 求助：５岁小孩高烧１０天
发信站: BBS 未名空间站 (Sat Feb 2 23:01:40 2013, 美东)
看了三次医生，没有任何进展。可能下周要收入院了。小地方没有儿童医院，也不知道
该不该换个别的医生。恳请大家帮着瞧瞧 （病人情况如下）。万分感谢。
5 yo female with persistent cough x 14 days and fever x 10 days. Fever runs
102-104 F, but does normalize when given motrin or tylenol. Symptom no
improvement after 4 days of Azithromycin. Began to have loose stool /watery
diarrhea for past 3-4 days. She had complained of abdominal pain (mostly... 阅读全帖 |
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M****a
发帖数: 577 | 22 ESR,CRP,ANA,RF
tagged RBC scan
Bowel sound auscultation
Step 2CS,Step 3 |
|
d**o
发帖数: 618 | 23 完全同意楼上各位大大。想问病人腰痛以来有没有测过血钙，尿常规含尿蛋白，PSA,
PTH, CRP, 还有腿痛的地方有没有拍过X光片？ |
|
x*****4
发帖数: 116 | 24 4月5日到日本旅游，
4月7日中午开始不肯吃饭，晚上呕吐，腹痛，
4月8日一天呕吐，腹痛
4月9日到京都市立医院，做了B超，CT, X-RAY..B超和XRAY说明肠部发炎，但CT显
示没有肠阻和肠打结。
4月10日开始住院，
4月11日开始用抗生素治疗，11日早上灌肠取出肠肉大便做细菌培养。结果是没有
细菌。同时当日开始服用azithromycin.但腹痛越来越厉害，呕吐胆汁黄绿色粘液。
4月13日凌晨因为腹痛又做了B超和CT, B超仍显示肠部发炎，但是CT显示没有肠阻
和肠打结.换抗生素certriaxone sodium hydrate. 13日到现在没有再呕吐，但13日晚
上开始便血，日本医院拿了大便和血液做细菌培养，结果仍没有发现细菌。
现在大便很稀，不受控制的流出，，有时有血，有时没有，血液检查CRP又升高了
一倍，孩子肚子疼起来只能靠止疼片，但是不疼的时候，头脑清醒，很活泼。另外孩子
从7日开始到现在不吃不喝，只靠点滴维持。爸妈都很着急，不知道该怎么办。想着明
天就带她回北京新世纪儿童医院治疗。
... 阅读全帖 |
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k******s
发帖数: 246 | 25 同意Aplusplus的第二眼. Kawasaki 是最靠前的鉴别诊断
- ESR, CRP, 监测Platelet
- Cardiology consult. ECHO to be done ASAP
- IVIG. High dose Aspirin
cat scratch, lymphoma, toxo 是需要排除 |
|
A*******s
发帖数: 9638 | 26 问你三个问题：
1. ESR/CRP 是多少？
2. 做颞动脉活检了吗？
3.有没有视力检查结果？
一般来说，64岁得这个病还是年轻了一些。 |
|
p****y
发帖数: 23737 | 27 我们应该详细了解不利于人体的9大衰老主因并避免它，这才是抗衰防老之道。人类
究竟为何会衰老？近代学者提出许多衰老的理论，例如：体内荷尔蒙分泌减少的理论、
体内自由基产生的理论、人体承受过大压力的理论、外界环境污染的理论、还有人体胰
岛素分泌抗拒性的理论等等。以下是现代医学对人类衰老主因的阐释。
不可忽视的自由基
自由基是携带不成对电子的分子、原子或离子。具有高度的化学反应性，容易和周
围分子起化学反应，使安定分子也变成自由基。如此重复，人体内就会不断产生新的自
由基，每天会有成千上万个自由基诞生。少数自由基是对人体有好处的，例如一氧化氮
(NO)。大多数自由基都是对人体有害的，含有不稳定的氧分子，具有强烈的氧化作用，
会给组织细胞带来氧化压力，破坏人体的健康。
1、它会攻击细胞膜，使细胞膜的流通性发生改变。
2、它会令细胞膜硬化，养分无法进入细胞，导致细胞老化或死亡。
3、它会攻击染色体双股或碱基，使染色体变异，有致癌症的可能。
4、它会攻击蛋白质，导致蛋白质变性，或与其他高葡萄糖分子联结成为复合体，引
发器官功能改变。
5、它会攻击粒腺体，导致粒腺体无法提供能源。
当人面在殊... 阅读全帖 |
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d******8
发帖数: 1972 | 28 好像没有什么影响。
http://finance.yahoo.com/news/amarin-reports-first-quarter-2012
BEDMINSTER, N.J., and DUBLIN, Ireland, May 8, 2012 (GLOBE NEWSWIRE) --
Amarin Corporation plc (Nasdaq:AMRN - News), a late-stage biopharmaceutical
company focused on cardiovascular disease, today announced financial results
for the quarter ended March 31, 2012 and provided an update on company
operations.
Amarin noted the following highlights since the quarter ended December 31,
2011:
Received Notice of Allowance for paten... 阅读全帖 |
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m****g
发帖数: 530 | 29 据8月5日《新英格兰医学杂志》在线发表的一项报告显示，无论男女，血清性激素结合
球蛋白(SHBG)水平低都强烈预示
着2型糖尿病风险增加，而水平高则预示着风险降低。
波士顿哈佛公共卫生学院理学博士Eric L. Ding及其同事指出，SHBG水平的预测能力可
能高于糖化血红蛋白水平和C反
应蛋白(CRP)水平等传统的危险因素。
这些结果是通过对妇女健康研究(Women’s Health Study，WHS)的数据进行多项不同的
分析得到，然后又在对医生健
康研究II(Physicians’ Health Study II)的数据所做的多项深层分析中得以重现。研
究者表示，“这些结果是通过对两个独
立队列采用多种分析法和做亚组分析获得，具有说服力且一致，证实性激素结合蛋白可
能在基因水平和表型水平对2型
糖尿病发病起着重要作用，而且SHBG可能是2型糖尿病发病风险分层和早期干预治疗的
一个重要靶点。”
据认为，SHBG的主要作用是结合循环中的激素，特别是与循环中的雄激素和雌激素相结
合。新近已有研究表明，SHBG
与糖稳态有关联，其基因的多处变异均与胰岛素抵抗有关。
Ding博士及其同事 |
|
j******3
发帖数: 18319 | 30 【 以下文字转载自 TAX 讨论区 】
发信人: ducan21 (ducan21), 信区: TAX
标 题: 包子求助 菜鸟问个税表的问题
发信站: BBS 未名空间站 (Thu Apr 1 00:03:56 2010, 美东)
在填property tax的表
搬过一次家，有两张CRP，填landlord的property ID number 的时候是不是两个都要填？
但是它默认好像只能填下一个。
前两个认真回答的每人一个包子
谢谢！ |
|
