n******e
发帖数: 1246 | 1 摘自nature immunology上的综述，引几个大家关心的段落吧
"Human infections usually occur after direct contact with virus in
dead or infected people or wildlife, with subsequent person-to-person
transmission. Filoviruses enter the body through mucosal surfaces or
skin abrasions or through the use of contaminated needles."
“Patients initially show nonspecific flu-like symptoms
such as fever, chills, malaise, muscle aches and headache. Abdominal
pain, nausea and vomiting may follow, and a cough, sore throat or diarrhea... 阅读全帖 |
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S*******s
发帖数: 10098 | 2 【 以下文字转载自 loseweight 讨论区 】
发信人: Gilda (屠龙公主,好女不跟女斗), 信区: loseweight
标 题: Re: 胰岛素抗性，老年痴呆，与全身衰老
发信站: BBS 未名空间站 (Sat Sep 8 12:03:23 2012, 美东)
那么Alzheimer Disease原理是什么呢？这个得从100多年前说起。
有个叫Alzheimer的医生，在一个50多岁，死于“dementia”的人脑子里面，发现了团
块状物质
后来多年研究，发现团块状物质是Amyloid Beta蛋白团，和一些tau蛋白丝。
我们知道，我们的思想，其实是神经元“放电”的过程（叫action potential），有时
候也叫firing
神经元之间通信，需要突触连接（synapse），中间可以认为是电化学过程。
神经正常的firing，和连接，就会产生Amyloid Beta蛋白。很多神经元，每秒fire上百次
就会产生很多Amyloid。我们可以暂且认为它是一种“废物”。正常年轻人中，这种废
物清除的很快
可以通过血液，进入肝脏和肾脏排出。也可以进入脑脊液（cer... 阅读全帖 |
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R*A
发帖数: 496 | 3 收工前学习了一下
从第一个图来看，CR F的寿命受的影响最大啊，年轻死亡的原因是什么？有没有控制生
育？是营养不够生育造成的死亡率升高吗？
另外，那个glucose的两个图，old onset的male的两条线是随着年龄增长diverge，
young onset的male却是converge，区别咋这么大啊？ |
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G***a
发帖数: 27294 | 4 那么Alzheimer Disease原理是什么呢？这个得从100多年前说起。
有个叫Alzheimer的医生，在一个50多岁，死于“dementia”的人脑子里面，发现了团
块状物质
后来多年研究，发现团块状物质是Amyloid Beta蛋白团，和一些tau蛋白丝。
我们知道，我们的思想，其实是神经元“放电”的过程（叫action potential），有时
候也叫firing
神经元之间通信，需要突触连接（synapse），中间可以认为是电化学过程。
神经正常的firing，和连接，就会产生Amyloid Beta蛋白。很多神经元，每秒fire上百次
就会产生很多Amyloid。我们可以暂且认为它是一种“废物”。正常年轻人中，这种废
物清除的很快
可以通过血液，进入肝脏和肾脏排出。也可以进入脑脊液（cerebrospinal fluid)进入
淋巴排出
而得了这种病的人，由于这些蛋白废物不能排出，就会自行结块。这些大蛋白块在脑子
里，就会
“糊住”神经元。由于这种大蛋白块有神经毒性，被“糊住”的神经元，就和其他神经
元失去联系
然后就死去。
同时，大蛋白块会引发脑中长期出现小量非针... 阅读全帖 |
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G***a
发帖数: 27294 | 5 那么Alzheimer Disease原理是什么呢？这个得从100多年前说起。
有个叫Alzheimer的医生，在一个50多岁，死于“dementia”的人脑子里面，发现了团
块状物质
后来多年研究，发现团块状物质是Amyloid Beta蛋白团，和一些tau蛋白丝。
我们知道，我们的思想，其实是神经元“放电”的过程（叫action potential），有时
候也叫firing
神经元之间通信，需要突触连接（synapse），中间可以认为是电化学过程。
神经正常的firing，和连接，就会产生Amyloid Beta蛋白。很多神经元，每秒fire上百次
就会产生很多Amyloid。我们可以暂且认为它是一种“废物”。正常年轻人中，这种废
物清除的很快
可以通过血液，进入肝脏和肾脏排出。也可以进入脑脊液（cerebrospinal fluid)进入
淋巴排出
而得了这种病的人，由于这些蛋白废物不能排出，就会自行结块。这些大蛋白块在脑子
里，就会
“糊住”神经元。由于这种大蛋白块有神经毒性，被“糊住”的神经元，就和其他神经
元失去联系
然后就死去。
同时，大蛋白块会引发脑中长期出现小量非针... 阅读全帖 |
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b***m
发帖数: 2112 | 6 恭喜破4~
应该跟gel没关系。赛前饮食、心态、比赛时没有恰当warm-up、喝水过量或过快等等可
能会有关联。
看下面文章，似乎没有明确原因。
http://www.runnersworld.com/ask-the-sports-doc/hiccups-after-ru
After longer runs (10 miles or greater) I keep coming down with the hiccups.
What the heck is going on?
Scott
Dear Scott,
Hiccups occur when the diaphragm contracts suddenly and unintentionally. The
diaphragm is your main breathing muscle and separates your lung space from
your abdominal space; as it contracts, the air is sucked into your lungs.
When running, t... 阅读全帖 |
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n**e
发帖数: 2026 | 7 【 以下文字转载自 Detective 讨论区 】
发信人: nile (nile), 信区: Detective
标 题: 尼罗河朱令案系列之10，诊断骗局之独处藏贼
发信站: BBS 未名空间站 (Sat Dec 6 10:12:21 2014, 美东)
在《诊断骗局之鱼目混珠》一文中，尼罗河揭示贝志城在中央电视台文献记录片中展示
的“远程诊断”不过是他自己从教科书上摘录的内容。人们不禁要问，既然贝志城声称
手里有上千份电邮回复，其中30%作出了铊中毒的正确诊断。一个绝对数字是48份邮件
作出了铊中毒的正确诊断。拿出一份邮件来给大家见识一下这个“正确诊断”应该是没
有问题的。贝志城之所以不能出示“正确诊断”并不是因为他手里没有这样的东西，而
是他遇到一道绕不过去的坎：时间限制性。注意下面这段对话（中央电视台文献记录片
《朱令的12年》）：
贝志城：十号发了那是个周一，周三我就给朱令他爸爸打电话说，我看到提问里还有说
是铊中毒。
贝志城：很多医生很激烈地发表意见，说一定要作这个化验，因为她的症状太像铊中毒
了。
朱令父亲：贝志城给我打了个电话，说有人觉得是不是就是铊中毒。
朱令母... 阅读全帖 |
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n**e
发帖数: 2026 | 8 核心提要：贝志城通过远程诊断帮助协和医生挽救了朱令的生命，他自己却在第二年被
北大“劝退”。这里面的全部秘密就在于一个关键问题：时间限制性。尼罗河对证据的
分析表明，所谓“远程诊断“不过是一个明修栈道的先知神话。
在《诊断骗局之鱼目混珠》一文中，尼罗河揭示贝志城在中央电视台文献记录片中展示
的“远程诊断”不过是他自己从教科书上摘录的内容。人们不禁要问，既然贝志城声称
手里有上千份电邮回复，其中30%作出了铊中毒的正确诊断。一个绝对数字是84份邮件
作出了铊中毒的正确诊断。拿出一份邮件来给大家见识一下这个“正确诊断”应该是没
有问题的。贝志城之所以不能出示“正确诊断”并不是因为他手里没有这样的东西，而
是他遇到一道绕不过去的坎：时间限制性。注意下面这段对话（中央电视台文献记录片
《朱令的12年》）：
贝志城：十号发了那是个周一，周三我就给朱令他爸爸打电话说，我看到提问里还有说
是铊中毒。
贝志城：很多医生很激烈地发表意见，说一定要作这个化验，因为她的症状太像铊中毒
了。
朱令父亲：贝志城给我打了个电话，说有人觉得是不是就是铊中毒。
朱令母亲：他（贝志城）说，阿姨你是怎么了，这么多人都说是... 阅读全帖 |
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n****n
发帖数: 492 | 9 i just want to talk about Alzheimer's disease. it is pretty much a
living bereavement because the patient cease to recognize their close
family and friends. for many years, it was believed that this disease
is seemingly sporadic. but now 3 genes(on chromosome 1, 14, 21) are
found to be linked to early onset of Alzheimer's, and one gene(ch 19)
to late onset of the disease. if one day we can pinpoint everybody's
genetic code, we can find those pool of population which is susceptible
to the dis |
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w*p
发帖数: 16484 | 10 Symptoms of Ebola virus disease
The incubation period, that is, the time interval from infection with the
virus to onset of symptoms is 2 to 21 days. Humans are not infectious until
they develop symptoms. First symptoms are the sudden onset of fever fatigue,
muscle pain, headache and sore throat. This is followed by vomiting,
diarrhoea, rash, symptoms of impaired kidney and liver function, and in some
cases, both internal and external bleeding (e.g. oozing from the gums,
blood in the stools). La... 阅读全帖 |
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g****1
发帖数: 261 | 11 http://www.bbc.co.uk/news/health-15552964
The onset of wrinkles, muscle wasting and cataracts has been delayed and
even eliminated in mice, say researchers in the US.
It was done by "flushing out" retired cells that had stopped dividing. They
accumulate naturally with age.
The scientists believe their findings could eventually "really have an
impact" in the care of the elderly.
Experts said the results were "fascinating", but should be taken with a bit
of caution.
The study, published in Nature,... 阅读全帖 |
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r*******y
发帖数: 48 | 12 backcrossing many generations in Tg study results in delay in the onset,
less severity or (to the extreme) even disappearance of the phenotype,
particularly in the heart field, has been observed in many labs which have
been working on Tg models. In some cases this phenomenon has nothing to do
with the position effect, or with mouse genetic background, becaseu it can
occur on independent lines with the similar genetic background. some labs
therefore had to repeatedly do the microinjection to gene... 阅读全帖 |
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m********a
发帖数: 3 | 13 http://www.google.com/url?q=http%3A%2F%2Fblogs.scientificameric
No one wants a hacking cough for days or weeks on end. But research
shows that it generally takes about 18 days to get over a standard cough-
based illness. Most of us grow impatient after a week or so and head to
the doctor to get a prescription. The problem with that recourse, however,
is that antibiotics are usually useless against typical respiratory
infections that cause coughs.
A new analysis shows that even tho... 阅读全帖 |
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w*******4
发帖数: 17 | 14 Pearls:
1. Whenever u see an HIV positive patient on pentamidine with seizure think
((pentamidine induced hypoglycemia..and check blood glucose!!))
2. The CT scan can be normal in 5% of patients with a subarachnoid
hemorrhage within the first 12 hours of headache onset. Between 24 and 72
hours from onset of headache, up to 25% of CT scans can be normal. Therefore
, if one suspects a subarachnoid hemorrhage from the patient's history, it
is imperative to perform a lumbar puncture to evaluate the |
|
k**e
发帖数: 2728 | 15 ☆─────────────────────────────────────☆
Mcdoudou (laowu) 于 (Fri Sep 10 01:50:41 2010, 美东) 提到:
看这个版也有几年了，一直觉得这个版挺和谐，有很多有用的帖子。我一般不大记得住
ID, 能记住的有老刀，acne, teabao, Eric， 还有一个前版主（个人偶像：此人在IT
浪潮时下海做了码工，考板热时成功考板match, 不记得ID了，只记得他的头像是他女
儿，极cute）。不过最近有点乱，有英语语法癖 （个人很反感，尽量跳过，跳不过就
只好当吃苍蝇了），有26岁问自己是不是太老的（use you common sense, please），
这不又有99er考经是不是炫耀贴。平心而论，有些是有一些炫耀的意味在里面。不过呢
，一是有可能不经意的，二是不影响交流。现在可好，有人抱怨一下，有人砸，乱了套
了。现在我带头发一下我的非99er考经和不成功的match经历。
个人情况：male, 老CMG, (15+), Ph.D无绿卡。
Step1: 06年3月底ebay拍到Kaplan ... 阅读全帖 |
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b****e
发帖数: 227 | 16 查了查harrison's practice,
pernicious anemia:
*peak age of onset is 60,only 10% of patients are <40 yrs
**but in some ethnic group(black and latin american),age onset is lower
***typical pernicious anemia can occur in children under 10(juvenile
pernicious anemia)
PA常并发autuimmune diz,而autoimmune diz常见与年轻人,这么联系起来按说应该是年
轻人多发.不过PA挺有意思,incidence increase with age...
但是好伐年龄也因为种族而不同.不查还真不知道阿 |
|
l********z
发帖数: 810 | 17 What is the answer, I choose D.
A 54-year-old African American woman has been in the intensive care unit (
ICU) for the past 10 hours because she has failed to regain consciousness
after passing out at a restaurant 11 hours ago. Upon initial arrival at the
emergency department the patient's friend stated that the patient had
remarked about the sudden onset of a terrible headache and neck stiffness
while they were having lunch. A few minutes after the onset of the headache,
she became confused, v... 阅读全帖 |
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h***y
发帖数: 834 | 18 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
|
h***y
发帖数: 834 | 19 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
|
w*l
发帖数: 43 | 20 刚考完CS， LA。 虽不经常来光顾， 但却从此处学了不少好经验。 趁着还没忘，先说
一下感受吧。前面已经有很多上品考经了， 就捡一些自己的切身感受说吧。 12 个
cases大概是FA 水准。如果能把FA 44个cases练过4遍左右， 不用太费劲就能不停地问
下一个问题的话， 那就差不多了。 这里说的4 遍是自己做医生， 而非做病人的练习
。本人是天资不够聪颖一类，只有多下功夫。
个人感觉：总的来说就是多看，多想，多练。这句话都知道也都会说的。
1. 起步：返回来想，最好一开始先争取理解CS。磨刀不误砍柴工。 有些材料挺好，
KAPLAN 5 day,UM, FA。KAPLAN 对入门很有好处，帮助理解， 建立思路，尤其是前面
的总论和介绍部分， 值得花时间捉摸。每一类的症状都有说明那些主要问题要考虑，
比方onset (acute or gradual), frequency, Quality/quantity, Alle/Aggr,
previous Episode and treatment, etc. 随后有differentials and workups. UW 也
... 阅读全帖 |
|
m******r
发帖数: 1904 | 21 ☆─────────────────────────────────────☆
wul (Wul) 于 h 提到:
刚考完CS， LA。 虽不经常来光顾， 但却从此处学了不少好经验。 趁着还没忘，先说
一下感受吧。前面已经有很多上品考经了， 就捡一些自己的切身感受说吧。 12 个
cases大概是FA 水准。如果能把FA 44个cases练过4遍左右， 不用太费劲就能不停地问
下一个问题的话， 那就差不多了。 这里说的4 遍是自己做医生， 而非做病人的练习
。本人是天资不够聪颖一类，只有多下功夫。
个人感觉：总的来说就是多看，多想，多练。这句话都知道也都会说的。
1. 起步：返回来想，最好一开始先争取理解CS。磨刀不误砍柴工。 有些材料挺好，
KAPLAN 5 day,UM, FA。KAPLAN 对入门很有好处，帮助理解， 建立思路，尤其是前面
的总论和介绍部分， 值得花时间捉摸。每一类的症状都有说明那些主要问题要考虑，
比方onset (acute or gradual), frequency, Quality/quantity, Alle/Aggr,
previous E... 阅读全帖 |
|
e****0
发帖数: 678 | 22 • Exaggerated deep tendon reflexes can be seen in lock in syndrome.
• Non bleeding varices are managed with nonselective beta-
adrenergic antagonists, such as propranolol.
• Sclerotherapy, endoscopic band ligation, and surgery are
indicated after a patient has a first episode of variceal bleeding.
• TIPS is a last resort in variceal bleeding unresponsive to
medical and endoscopic intervention.
• Ischemic colitis
CT—thickening of eth bowel ... 阅读全帖 |
|
d*********n
发帖数: 18 | 23 Confusion case: O CFDP P ADL, IADL, TIA/stroke, depression, DM, thyroid,
normal pressure hydrocephalus, PAMHUGSFOSS
insulin induced hypoglycemia
Electrolyte abnormalities
Vitamin B12 deficiency
Medications
TIA
Multi-infarct dementia
Chronic subdural hematoma
Alzheimer’s dementia
Normal pressure hydrocephalus
Intracranial tumor
Neurosyphilis
Depression
Hypyothyriodism
DDx Confusion
DEMENTIA
D-Diabetes /Dementia/ Drugs
E-Epilepsy
M-Migraine/Mult Infarct Dementia
E-Ethanol (withdrawl / Toxicity)
N... 阅读全帖 |
|
m**********d
发帖数: 137 | 24 接下来面了一个家门口的pg，这次风格迥异
9个candidates一起面，4个AMG （其中2个申prelim），4个印度人（1个女的年纪比较
大，另外3个应该是fresh grad）
这次跟3个faculty member面。第一个是PD，她人很和蔼，上来便问我在extern期间学
到了啥，有啥interesting patient，我很从容地讲了一些自己的经历和体会。然后她
问我free clinic的Dr.C and Dr. P (他们都认识，且Dr.P是他们pg的previous pd)，
”they have put in a lot of good words about you”，我的天，看来平时积累人品
真的很重要，我没主动请人家帮忙，人家竟然也说了些我的好话，真是阿弥陀佛。然后
她问我有啥question。面试其间我着重强调了，自己在local，非常想留在这里，对他
们pg也是仰慕已久，感觉PD很positive，“definitely, we are going to highly
consider you”。跟PD过招，这次没给自己留太大的遗憾。
第二面是跟ass... 阅读全帖 |
|
l*******8
发帖数: 1745 | 25 40y AAF severe obese,new onset massive PE, b/l upper and lower lobes and R
middle lobe pulmonary artery emboli, r back pain and sob 4 days, no any PMH
except psych histry, no travel histry, not taking OCP, no family histry of
DVT or PE, this is her first time onset
the key is vitals are stable, oxygenation is good on room air, little bit
sinus tacky, I report to PCP and asked him what his treatment plan is:
anticoagulation v.s. thrombolytic therapy ( acturally only unstable pt will
use thromboli... 阅读全帖 |
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y******7
发帖数: 17 | 26 The following is what I collected when I was a student doing capstone in a
local hospital. Not sure if it is useful.
Lidocaine topical is a amide-type local anesthetic. for production of
topical anesthesia, relief of pain associated with postherpetic neuralgia,
reduction of gagging during dental procedures, prevention and control of
urethral pain, anesthetic lubricant for endotracheal intubation, and relief
of hemorrhoidal pain.
Polyethylene glycol(Miralax) is a nonabsorbed solution used to trea... 阅读全帖 |
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c**t
发帖数: 316 | 27 DSM-5诊断标准的改变
邓明昱博士（Miller Deng, M.D., Ph.D）整理
《精神疾病诊断与统计手册》第5版（DSM-5）已于2013年5月18日由美国精神病协会(
APA)在美国正式出版，此本书的特点在于对某些精神疾病疾病提高其“诊断特异性”标
准(也就是诊断准严格要求排除真正没有精神疾病的人)且降低其“诊断敏感性”(亦即
某些可能有精神疾患前驱症状不再被确诊为“疾患”)，除此之外DSM-5尝试使用光谱系
统(Spectrum)，疾患将不再只是“类别分类”。
DSM-5最著名的诊断标准改变为亚斯伯格症不再独立诊断出来，而精神分裂症的各亚型(
妄想型、紧张型、混乱型、残余型)也都去除，而哀恸反应(bereavement)也可包含于忧
郁症里面而不再相斥。而性别认同的准则则大幅修改，并且新增加了赌博性疾患(
gambling disorder)。
【各诊断标准改变如下】:
[神经发育障碍(Neurodevelopmental disorders)]
心智发展迟缓(... 阅读全帖 |
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c**t
发帖数: 316 | 28 DSM-5诊断标准的改变
邓明昱博士（Miller Deng, M.D., Ph.D）整理
《精神疾病诊断与统计手册》第5版（DSM-5）已于2013年5月18日由美国精神病协会(
APA)在美国正式出版，此本书的特点在于对某些精神疾病疾病提高其“诊断特异性”标
准(也就是诊断准严格要求排除真正没有精神疾病的人)且降低其“诊断敏感性”(亦即
某些可能有精神疾患前驱症状不再被确诊为“疾患”)，除此之外DSM-5尝试使用光谱系
统(Spectrum)，疾患将不再只是“类别分类”。
DSM-5最著名的诊断标准改变为亚斯伯格症不再独立诊断出来，而精神分裂症的各亚型(
妄想型、紧张型、混乱型、残余型)也都去除，而哀恸反应(bereavement)也可包含于忧
郁症里面而不再相斥。而性别认同的准则则大幅修改，并且新增加了赌博性疾患(
gambling disorder)。
【各诊断标准改变如下】:
[神经发育障碍(Neurodevelopmental disorders)]
心智发展迟缓(... 阅读全帖 |
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a*****y
发帖数: 361 | 29 【 以下文字转载自 EnglishChat 讨论区 】
【 原文由 neuron 所发表 】
i just want to talk about Alzheimer's disease. it is pretty much a
living bereavement because the patient cease to recognize their close
family and friends. for many years, it was believed that this disease
is seemingly sporadic. but now 3 genes(on chromosome 1, 14, 21) are
found to be linked to early onset of Alzheimer's, and one gene(ch 19)
to late onset of the disease. if one day we can pinpoint everybody's
genetic code, we can find those poo |
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A*******s
发帖数: 9638 | 30 A real case to share:
A 67 yrs old female, with a history of HTN, presented with syncope. She
complained of a sudden onset of vertigo then LOC for 1 min. She was very
confused at the admission.
PMH: HTN.
SH: No smoking/ETOH
FMH: HTN
ROS: not remarkable except mild confusion.
PE: VSS stable. BP: 140/80 bilaterally per record.
OA x 2 and CVS:irregularly irregular. Other exams were not remarkable.
CNC/CMP/PT/PTT: nl
Cardiac enzyme: neg
EKG showed A-Fib （new onset).
A CT of brain was neg.
Carotid ... 阅读全帖 |
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A*******s
发帖数: 9638 | 31 A real case to share:
A 67 yrs old female, with a history of HTN, presented with syncope. She
complained of a sudden onset of vertigo then LOC for 1 min. She was very
confused at the admission.
PMH: HTN.
SH: No smoking/ETOH
FMH: HTN
ROS: not remarkable except mild confusion.
PE: VSS stable. BP: 140/80 bilaterally per record.
OA x 2 and CVS:irregularly irregular. Other exams were not remarkable.
CNC/CMP/PT/PTT: nl
Cardiac enzyme: neg
EKG showed A-Fib （new onset).
A CT of brain was neg.
Carotid ... 阅读全帖 |
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f****o
发帖数: 2770 | 32 感谢大家支招
当时那个intern order了meperidine 12.5mg-25mg IVP Q4hrs for overnight until
day shift people come in。我也让这个order过了。
我也没啥办法了(其实可以oxycodone rectally，估计病人也不会同意的)
但是pain pharmacist不让我以后approve meperidine for pain，说seizure has been
reported after single dose meperidine in patient with normal renal function
. 但是呢，她又不给我一个recommendation，我就想说以后又发生酱紫的情况咋办。
那个病人手术之前有没有take long acting opioid/有无chronic pain issue我已经不
记得了。fentanyl patch onset很慢，等onset了天就亮了day shift就来了也就没我的
事情了。
fentanyl IVP不是说nurse不能push on ... 阅读全帖 |
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h******y
发帖数: 22 | 33 early onset dementia有presenile dementias 和senile dementias with early
onset，DDXs 多去了vascular dementia，frontotemporal dementia, head injury,
alcohol intoxication, metabolic disorder, progressive supranuclear palsy,
and corticobasal degeneration......不知道详情就别乱猜了 |
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e*****i
发帖数: 993 | 35 对了，忘了说了，这个很重要。
light therapy的鼻祖Norman E. Rosenthal说，主要是眼睛，要让眼睛感受到光,不要直接看强光，但是要让部分光线进入眼睛。
melatonin的合成是发生在皮肤的，我不知道抑制是不是也是作用在皮肤，我还在进一步研究。下面是关于melatonin的基本信息。
http://en.wikipedia.org/wiki/Melatonin
Light dependence
Production of melatonin by the pineal gland is inhibited by light and permitted by darkness. For this reason melatonin has been called "the hormone of darkness" and its onset each evening is called the Dim-Light Melatonin Onset (DLMO). Secretion of melatonin as well as its level in the b |
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p**********d
发帖数: 7918 | 36 http://www.nytimes.com/2011/04/04/world/asia/04museum.html?_r=1
April 3, 2011
At China’s New Museum, History Toes Party Line
By IAN JOHNSON
BEIJING — At the elaborately renovated National Museum of China in
Tiananmen Square, visitors interested in the recent history of the world’s
fastest rising power can gaze at the cowboy hat that Deng Xiaoping once wore
when he visited the United States, or admire the bullhorn that President Hu
Jintao used to exhort people to overcome hardship after the Sichu... 阅读全帖 |
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c**i
发帖数: 6973 | 37 supports archaeology, that a single-origin domestication 8 to 9,000 years
years ago at Yangtze Valley (of China) and spread to India, rather than the
competing proposition that Ganges in India independently accomplished the
feat.
研究显示:中国是驯化水稻的原产地. VOA Chinese, May 3, 2011.
http://www.voanews.com/chinese/news
/international/20110503-RICE-ORIGIN-121155584.html
, which cites
Molina J et al, . Proceeding of National Academy Science (PNAS), published
online before print May 2, 2011, doi: 10.1073/pna... 阅读全帖 |
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x******g
发帖数: 33885 | 38 大家看看吧：美国像不像个第三世界？
所以根据这些事实，我觉得轮子们，茉莉花党徒们，普世接轨党们在政治上都很幼稚啊！
Hunger in the United States
Three years after the onset of the financial and economic crisis, hunger
remains high in the United States. The financial and economic crisis that
erupted in 2008 caused a dramatic increase in hunger in the United States.
This high level of hunger continues in 2010, according to the latest
government report (with the most recent statistics) released in September
2011 (Coleman-Jensen 2011).
•In 2010, 17.2 ... 阅读全帖 |
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J*V
发帖数: 3150 | 39 Recession Left Baby Bust as U.S. Births Lowest Since 1920
By Frank Bass - Nov 30, 2012 12:01 AM ET.
.
Facebook Share
LinkedIn
Google 1
73 Comments
Print
QUEUE
Q
..
Getty Images
The U.S. birth rate in 2011 was 63.2 per 1,000 women of childbearing age,
according to preliminary numbers. That’s down by almost half from a peak of
122.7 in 1957 during the postwar baby boom.
The U.S. birth rate fell to a record low last year, driven by a decline in
the number of babies born to immigrant women, who hav... 阅读全帖 |
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g******t
发帖数: 18158 | 40 你喜欢被打脸，哥今天就再成全你一次
"Shtrafbat"
Pursuant to Order No. 227, any attempt to retreat without orders, or
even a failure to advance was punished by barrier troops
('zagraditel'nye otriady') or "anti-retreat" detachments of the Soviet
special organization known as SMERSH (Smert shpionam), Russian for
"Death to spies".[16][17] SMERSH units were used to shoot retreating
men serving in penal units should the latter commence a retreat after
failing either to advance to secure an objective, or to stop a Germ... 阅读全帖 |
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P*****l
发帖数: 438 | 41 Arab League supports Abbas's decision to halt talks
By JPOST.COM STAFF, HERB KEINON AND KHALED ABU TOA
10/08/2010 22:45
Foreign ministers meeting in Libya back PA president's decision to stop
negotiations as long as Israeli building in settlements continues; express
hope the US will continue to pressure J'lem to renew freeze.
Talkbacks (1)
The Arab League announced on Friday that it supports Palestinian Authority
President Mahmoud Abbas's decision to stop peace talks with Israel following
Israe... 阅读全帖 |
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T**********r
发帖数: 1223 | 42 http://web.stratfor.com/images/writers/CHINA_RARE_EARTH_ELEMENTS.pdf?fn=9617327557
China and the Future of Rare Earth Elements
October 14, 2010
clip_image002
STRATFOR
PDF Version
* Click here to download a PDF of this report
A recent diplomatic spat between China and Japan has heightened territorial
tensions and called attention to China’s growing forcefulness with foreign
powers. One of the more intriguing aspects of this development was China’s
suspension of the export of “rare ea... 阅读全帖 |
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w*********g
发帖数: 30882 | 43 美国后面将要面临的另外一个巨大问题（组内讨论稿） (2011-05-31 23:16:32)转载标
签： 财经
文章来源http://www.niwota.com/submsg/5788837
Alt-A和option ARM或将引发新一轮金融危机
次级抵押贷款危机（简称次贷危机）之后，Alt-A和选择性可调整利率贷款（
option ARM）将是另外两颗等待引爆的定时炸弹。
美国住房抵押贷款市场可分为三个档次，优质(Prime)贷款面向信用等级高的客户(
信用分数在660分以上)；次级（Subprime）贷款通常指信用分数低于620分，收入证明
缺失，负债较重的人；而Alt-A贷款介于两者之间。
对于选择性可调整利率贷款来说，买房者在最初几年只需要每月按揭支付非常低的
利息（如1%），人们给这种利率取了个名字“引逗利率”，因为等到2年、3年或者5年
之后，重新设定利率时，买房者每月还款会大幅增加，甚至上涨数倍。
Alt-A和选择性可调整利率贷款的利率正开始大规模调整，而现在它们的违约率已
经非常惊人。Alt-A和option ARMs贷款的违约率最终将和次级贷款一样高，达到50%，... 阅读全帖 |
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j***h
发帖数: 4412 | 44 Taxpayers Rank Behind Solyndra Investors
By William McQuillen - Sep 3, 2011 7:00 AM PT
The Obama administration let $385 million in taxpayer support for Solyndra
Inc. take a back seat to funds from new investors in an unsuccessful effort
to keep the solar-panel manufacturer operating.
The Energy Department decided the January refinancing represented the “
highest probable net benefit” for the government, according to a government
document obtained by Bloomberg News. Investors provided the compan... 阅读全帖 |
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e****i
发帖数: 2152 | 45 Biblical Age of Earth
by David V. Bassett, M.S.
Beginning with the archeological landmark event of the fall of Jerusalem (
which has now been corrected to 588 B.C., instead of 586-587 B.C.) and
counting backwards the prophesied number of years between this event and the
division of Solomon's kingdom (390 yrs. + 40 yrs., according to Ezekiel 4:4
-7), brings us to 1018 B.C.
From the end of Solomon's 40-year reign to the start of the Temple in the
4th year of his reign takes us back another 37 yea... 阅读全帖 |
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x******g
发帖数: 33885 | 46 【 以下文字转载自 ChinaNews 讨论区 】
发信人: xinchong (新葱是官二代), 信区: ChinaNews
大家看看吧：美国像不像个第三世界？
所以根据这些事实，我觉得轮子们，茉莉花党徒们，普世接轨党们在政治上都很幼稚啊！
Hunger in the United States
Three years after the onset of the financial and economic crisis, hunger
remains high in the United States. The financial and economic crisis that
erupted in 2008 caused a dramatic increase in hunger in the United States.
This high level of hunger continues in 2010, according to the latest
government report (with the most recent statistics) release... 阅读全帖 |
|
l*x
发帖数: 891 | 47 请观看这段录像，从2:00开始：
http://www.youtube.com/watch?v=6WQtRI7A064
"The world today has 6.8 billion people. That's heading up to about nine
billion. Now if we do a really great job on new vaccines, health care,
reproductive health services, we could lower that [number of 9 billion] by
perhaps 10 or 15 percent. But there we see an increase of about 1.3 [billion
]."
Let's focus on the vaccines. Gates is stating that he considers vaccines to
be useful in contributing to bring the projected population grow... 阅读全帖 |
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u***r
发帖数: 4825 | 48 http://www.nytimes.com/2012/01/12/world/asia/taiwan-vote-lures-
BEIJING — The only thing more striking than the $32,000 diamond-encrusted
eyeglasses on display at the Baodao Optical department store here is the
bronze statue of Chairman Mao that greets shoppers entering what is billed
as the world’s largest eyeglass emporium.
That is because Baodao Optical’s owners are from Taiwan, the island whose
governing party, the Kuomintang, fought a fierce — and losing — civil war
against Mao’s Communist ... 阅读全帖 |
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K**********n
发帖数: 1197 | 50
跟这帮自称理科的文科生物wsn实在纠缠不清楚。给丫们上点洋大人自己的说法吧，而
且都是学术圈的，已有reference一堆，其中一份是著名的兰德公司的报告。
另外，美国和澳洲已立法限制使用脑波扫描仪，拿脑波扫描仪扫本国公民已是联邦法的
重罪。不过这个比较难的是你无法证实谁接收了你的脑信号。所以立了法跟没立一个样。
Remote Mind Control Technology
Reprinted from SECRET AND SUPPRESSED: BANNED IDEAS AND HIDDEN
HISTORY, edited by Jim Keith, $12.95, available from
1-800-680-INET.
There had been an ongoing controversy over health effects of electromagnetic
fields (EMF) for years (e.g., extremely low frequency radiation and the
Navy's Project Sea... 阅读全帖 |
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