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A 58-year-old female was referred to our department with intermittent suffocation for 1.5 years, aggravated for a month. 1.5 years before she developed oral ulcer, raynaud phenomenon, proteinuria, bilateral pleural effusion, ANA and anti-dsDNA positive. This patient was diagnosed with systemic lupus erythematosus (SLE). After given hormones, hydroxychloroquine sulfate (HCQ), her symptom relieved soon. The patient stopped her pills 1 year ago. One month ago, she had chest tightness, increased urine foam, and suffered from oliguria. Her admission medical examination: blood pressure (BP) 130/80 mmHg, conjunctiva pale, and lower lung breath sounds reduced. There was no tenderness, rebound pain and abdominal muscle tension in the abdomen. Liver and spleen rib inferior, mobile dullness negative, and lower extremity edema. Blood routine tests were performed with hemoglobin (HGB) 57 g/L. Urine routine: BLD (3+). 24-hour urinary protein 3.2 g. serum albumin 20.5 g/L, C-reactive protein (CRP) 12.85 mg/L, erythrocyte sedimentation rate (ESR) 140 mm/h. Antinuclear antibody (ANA) (H)1 ∶10 000;, anti-dsDNA antibody 1 ∶3 200;, anti-Smith antibody, anti-U1-snRNP / Sm antibody were positive, blood complement 3(C3) 0.43 g/L, complement 4(C4) 0.07 g /L. Anticardiolipin antibody (ACL), anti-β2-GP1;, lupus anticoagulant (LA) were negative, HRCT suggested bilateral medial pleural cavity product liquid. Admission diagnosis: SLE lupus nephritis, anemia, pleural effusion, and hypoproteinemia. We treated her with methylprednisolone 1 000 mg×3 d;, late to 48 mg/d and cyclophosphamide 1.0 g, HCQ 0.2 g bid, gamma globulin 10 g×5 d. Day 2 of treatment;, this patient developed acute right upper quadrant pain, not accompanied by nausea, vomiting, blood stool and diarrhea. Antipyretic antispasmodic treatment was invalid, after the morning to ease their own abdominal pain. Day 4 of treatment, daytime blood HGB 77 g/L. Bilateral renal vascular ultrasound: bilateral renal artery blood flow velocity was reduced. The abdominal pain of the above symptoms recurred at night, BP was 120/80 mmHg, and no positive signs were found on abdominal examination. No abnormality was found in the vertical abdominal plain film. Blood routine examination: HGB 53 g/L, Plasma D dimer 2 515 μg/L;, amylase in hematuria was normal, the stool occult blood was negative. Abdominal computed tomography (CT): normal structure of right adrenal gland disappeared, irregular mass shadow could be seen in adrenal region, CT value was about 50 HU. Morphological density of left adrenal gland was not abnormal. The retroperitoneum descended along the inferior vena cava to the right iliac blood vessel and showed a bolus shadow. The density of some segments increased. The lesion involved the right renal periphery and reached the left side of abdominal aorta. Most lesions surrounded the inferior vena cava, the right renal vein and part of the small intestine. The boundary between the upper lesion and the vena cava was unclear. Iodine-containing contrast agent was taken orally. No sign of contrast agent overflowing was found in the abdominal cavity. Hematoma and exudative changes were considered in retroperitoneum. Conclusion of contrast-enhanced ultrasound of blood vessels: The retroperitoneal inferior vena cava (volume 3.5 cm×3.5 cm×1.5 cm) was hypoechoic and had no blood flow lesion. The adrenal gland had a high possibility of origin. Left renal vein thrombosis extended to inferior vena cava. According to the above data;, it was analyzed that the cause of retroperitoneal hematoma of the patient was left adrenal vein thrombosis caused by hypercoagulable state, which led to vascular rupture and hemorrhage caused by increased vascular pressure in adrenal gland. Therefore, on the basis of continuing to actively treat the primary disease, and on the basis of dynamic observation of no active hemorrhage for 3 days, the anticoagulant therapy was continued with 10 mg/d of apixaban. Clinical symptoms were gradually eased, HGB did not decrease. Two weeks later, the ultrasonic examination showed that the irregular cluster hypoechoic range behind the inferior vena cava was significantly smaller than that before (1.8 cm×1.2 cm×0.7 cm). Abdominal CT examination after 1 month showed that there was no abnormal morphological density of bilateral adrenal glands and basic absorption of retroperitoneal exudation. Adrenal hemorrhage is uncommon. SLE with adrenal hemorrhage is rarer. In SLE patients;, especially those complicated with APS, if abdominal pain accompanied by HGB decrease occurs, except after gastrointestinal hemorrhage, the possibility of adrenal hemorrhage should be warned.  相似文献   
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目的:建立蒙成药小儿清肺八味丸中羟基红花黄色素A的含量测定方法。方法:采用HPLC法,应用Agilent TC-C 18色谱柱(4.6 mm×250 mm,5μm),流动相为甲醇-乙腈-0.7%磷酸水溶液(16∶1∶83),用三乙胺调pH值为6.0,流速1.0 mL·min^-1,柱温30℃,进样量为10μL,检测波长为403 nm。结果:羟基红花黄色素A进样量范围在0.10~2.00μg时,进样量与峰面积线性关系良好(r=0.9999);平均回收率为102.48%,RSD为1.52%。结论:该方法简便、灵敏、准确,可用于小儿清肺八味丸中羟基红花黄色素A的测定。  相似文献   
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目的探讨腔隙性脑梗死患者血清趋化素(Chemerin)、丝氨酸蛋白酶抑制剂(Vaspin)及脂肪素(Apelin)水平及意义。方法选取2018-01—2019-03在河南科技大学第一附属医院治疗的腔隙性脑梗死患者120例(观察组),其中轻度32例,中度61例,重度27例,同时选取健康志愿者100例为对照组,检测2组血清Chemerin、Vaspin和Apelin,观察组给予常规治疗。结果观察组血清Chemerin和Apelin分别为(60.03±10.02)mg/L和(180.02±41.12)μg/L,明显高于对照组(P<0.05),而Vaspin为(6.72±1.01)μg/L,明显低于对照组(P<0.05);观察组重度患者血清Chemerin和Apelin分别为(72.44±13.30)mg/L和(209.34±50.28)μg/L,明显高于轻度和中度患者(P<0.05),而Vaspin为(4.23±0.92)μg/L,明显低于轻度和中度患者(P<0.05);中度患者血清Chemerin和Apelin分别为(62.22±12.28)mg/L和(180.02±41.18)μg/L,明显高于轻度患者(P<0.05),而Vaspin为(6.72±1.09)μg/L,明显低于轻度患者(P<0.05);Chemerin和Apelin与DNS评分呈正相关(r=0.332、0.319,P<0.05),而Vaspin与DNS评分呈负相关(r=-0.422,P<0.05);观察组治疗后血清Chemerin和Apelin较治疗前降低(P<0.05),而Vaspin较治疗前升高(P<0.05)。结论腔隙性脑梗死患者血清Chemerin和Apelin明显升高,而Vaspin明显降低,与神经功能缺损程度有一定关系。  相似文献   
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本文在文献研究基础上,并结合个人实践经验和认识,对蒙医药的理论体系、用药特点以及发展状况等进行了综述,为蒙医药的研究提供理论依据。  相似文献   
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研究肉豆蔻-8散提取物对心肌细胞缺氧/复氧损伤的保护作用及其与酪氨酸蛋白激酶2(JAK2)/信号转导子和激活子3(STAT3)信号通路的关系。使用连二亚硫酸钠(Na2S2O4)建立H9c2细胞缺氧/复氧损伤模型;采用CCK-8法检测细胞活力;采用全自动生化分析仪检测细胞培养液中乳酸脱氢酶(LDH)、磷酸肌酸激酶(CK)和天冬氨酸氨基转移酶(AST)的含量;采用试剂盒法测定细胞中过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)的含量;采用Hoechst染色法检测细胞凋亡程度;采用蛋白免疫印迹法(Western blot)检测各组心肌细胞JAK2、p-JAK2、STAT3、p-STAT3、Bcl-2、Bax的蛋白表达。Na2S2O4对H9c2细胞活力的半数抑制量为2mmol/L;与模型组比较,不同浓度肉豆蔻-8散提取物均能提高细胞活力;能显著降低细胞培养液中CK、LDH、AST的水平、能显著增加细胞中CAT、SOD、GSH-Px的水平;同时可显著增加p-JAK2、p-STAT3、Bcl-2的蛋白表达、显著减少Bax的蛋白表达,而AG490阻断剂组可减弱肉豆蔻-8散提取物的作用。肉豆蔻-8散通过JAK2/STAT3信号通路发挥对Na2S2O4诱导缺氧/复氧损伤心肌细胞的保护作用。  相似文献   
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目的分析方城县1953-2014年疟疾发病趋势和流行规律,为消除疟疾工作提供依据。方法收集、整理方城县1953-2014年疟疾疫情资料、不同时期所采取的防治措施等,对相关资料进行回顾性分析。结果方城县疟疾防治工作经过60余年的综合防控,取得了显著的效果,发病率从1953年的2810/10万降至1992年的0.42/10万,1992年经考核达到了卫生部基本消灭疟疾的标准,2012年以来连续3年无本地感染病例。结论今后应建立多部门的合作机制,加强输入性疟疾的防控和管理,切实落实各项防控措施,达到消除疟疾的目标。  相似文献   
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