Can eat the health after winding the hot pot of the trap
Trap 1 Rough, hot, hot
Oral cavity, gullet and stomach mucous membrane can only generally tolerate 50~60 , and the temperature of thick soup of hot pot can be up to 120 , the food is cooked by scalding promptly if eating, it is very apt to scald oral cavity, esophagus and stomach mucous membrane. In addition, chilli,etc. is stimulated, it is apt to cause or bring out various digestive organs inflammation and ulcer.
The expert reminds: Would rather give up the three kinds of delicacies, don't be hot
Food pull out, had better place little disc on wait a little cool to eat any more first in pan, have people, digestive tract of disease actually, eat the hot pot with the light hot pot of little oil, little chilli.
Trap 2 Tender
If it is tender to seek simply, it is very ripe not to wait for the food yet and eat, not merely influence the digestion and absorption of the nutrient component, still perhaps bacterium and parasite killed because among them cause the gastrointestinal infection.
The expert reminds: Don't half eat the prepared food
Would rather die some mouthfeel, should rinse the meat very ripely and eat any more even. Certainly, if food boil for a long time, too can cause nutrient component destroy, can take food after being generally hot and soft.
Trap 3 " nutrition " Soup
In the hot pot soup after boiling repeatedly, it have mostly already been destroyed that vitamin,etc. benefited the compositions, and harmful compositions such as saturated fat, sodium salt, purine,etc. are a lot of, these compositions are the inducements of many kinds of chronic diseases such as fat, diabetes.
The expert reminds: Drink and boil the soup of hot pot for a long time few
Burn to boil time in the soup of hot pot in over 60 minutes, the content of inferior nitrate in its decoction rises rapidly, want to taste the delicious bad smell of the soup of hot pot, will drink soon shortly after boiling, and drink few. High urine acidaemia and patient of the gout medical history had better touch little hot pot, or take food with low purine as the core, if vegetables,etc..
Trap 4 " protracted war "
The hot pot is eaten for several hours, and take meat of high fat content as the core, the gastrointestinal tract must secrete digestive juice continuously, for a long time so, will cause the disorders of digestion, may initiate many kinds of " rich man's diseases " because protein, fat take in too much .
The expert reminds: Control within 2 hours
It is apt to get angry that the hot pot has been eaten too much, do not exceed once a week, and had better limit to 2 hours each time. In addition, don't forget staple food, vegetables, meat and beans,etc. are matched and taken food.
The editor recommends:The wine of fruit is nutritious but don't be drunk on an empty stomachHow to avoid encroaching on the nutriment?
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Thursday, January 31, 2013
Leave some small suggestions of a marriage on the man 30 years old
Leave some small suggestions of a marriage on the man 30 years old
30 year old whether man discuss the intersection of wedding and best opportunity that theory marry, woman who they looked for probably about 25 years old, because according to analysing scientifically, men and women differ by 3 to 5 years old, can let men and women's facial old and feeble process reach unanimity, so on the issue to it is more slowly old than the woman not to present men, two people can settle down to enjoy " age together " Romance. Essence of love of two sexes unequal from ancient times to the present, act as man run into beauty yes so competent as to come out, otherwise will not have " Love not country but beauty " Story. This that certainly excluding those have never understood what has been a play-boy of the love ---They will not consider for terminal, but consider conquering the next mountain peak. But not bad, it is already enough for most men to just hope to have a true love, because this has been already very difficult, it is exactly the essential proposition in the decent man's life to look for wife women.
Some the first day meet one old person in cultural circles, to rebuke the intersection of Zha and idol of publish circle too in Hong Kong at that time, though about fifty years of age in nowadays, long hair float and elegance just like one's old self still, I think such a man must read the red man's green woman thing to the limit, then will take advantage of me afterwards the people's identity will be asked him about the view on the woman.
"In fact the men all like the goodlooking woman, it is the most important to be though kindhearted, warm-hearted, but the man absolutely vision controls the animal of the brain " --Even arrived " Do not exceed the rule " Age last enticement,continue he say whether " but it is dream of to talk about by women ultimate, I think that have something to do with age. "
The fact is really like this, all of us know first love is incomparably bright, but can't almost repair into a right fruit, trace it to its cause to ascribe to the boy at that time and does not know what kind of woman oneself wants - -Even beautiful ugly standards are all ambiguous. Can be proved with an example: Classmates had a get-together a few days ago, I found it " the class spent " which we pursued that year Have good looks at all at all, so that reduce to to be married stage with ugliest girl into the class. The ones that can be seen we that year are aesthetic and ignorant.
As a man knew how to distinguish beautifully at last, but began to make mistakes on the outlook on life. Super male chauvinism person, think all OK if like, home environment, education background are not considered at all, then a lot of love tragedies were born when a pair of beautiful women got into the society. Can't shoulder living burden, is only full of departure of sad feelings in male chauvinism. Individual thinks often the injury that the man receives is greater on such a thing - -Having shouldered for a lot of years the heavy head will have been here agained, it is a very miserable thing to really get.
Remember a boss has said to me: "20 year old man have by nothing, but 20 -year-old girl there is any other things; 40 -year-old man have by everything, but 40 -year-old woman there is not any other things. " So he advise me spend energy on, strive for, have, have kind by everything by 40 year old, don't play with the emotion during 20 years old. So the meddler summarizes the following definition, according to the present state of development of society of our country, a man - -Plane inside except that son of vast wealth, look at the intersection of love and substantially as playing play-boy and other to regard marriage as the intersection of love and all sorts of man of terminal - -The target most suitable for the love is:
Woman earning one's own living - -The woman with independent economy generally has ability of good psychology and rational thinking;
Woman that the look is a bit more goodlooking than oneself - -So can meet the man's Vanity, but can't be much, otherwise the woman will think that marry losing, will bully you all one's life;
Aesthetic and unanimous woman - -If you like seeing the science fiction film, don't look for a woman liking seeing the literary film; If you like Wang Fei, don't look for a girl who likes Li Yapeng, though Wang Li two people have already got married!, that is not all right.
The above three are to give a man's suggestion of about 30 years old - -This is the best opportunity that a man discusses the wedding theory and marries, the woman who they looked for is probably about 25 years old, because according to analysing scientifically, men and women differ by 3 to 5 years old, can let men and women's facial old and feeble process reach unanimity, so on the issue to it is more slowly old than the woman not to present men, two people can settle down to enjoy " age together " Romance.
Say the scheme, man realize, stand up, still fill dangers about ultimate dream of woman, the older generation says that Hong Kong that location is cultural: "Can only look for the appropriate woman with a principle by today just like I, that ' who like I, who I like right away '. "
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30 year old whether man discuss the intersection of wedding and best opportunity that theory marry, woman who they looked for probably about 25 years old, because according to analysing scientifically, men and women differ by 3 to 5 years old, can let men and women's facial old and feeble process reach unanimity, so on the issue to it is more slowly old than the woman not to present men, two people can settle down to enjoy " age together " Romance. Essence of love of two sexes unequal from ancient times to the present, act as man run into beauty yes so competent as to come out, otherwise will not have " Love not country but beauty " Story. This that certainly excluding those have never understood what has been a play-boy of the love ---They will not consider for terminal, but consider conquering the next mountain peak. But not bad, it is already enough for most men to just hope to have a true love, because this has been already very difficult, it is exactly the essential proposition in the decent man's life to look for wife women.
Some the first day meet one old person in cultural circles, to rebuke the intersection of Zha and idol of publish circle too in Hong Kong at that time, though about fifty years of age in nowadays, long hair float and elegance just like one's old self still, I think such a man must read the red man's green woman thing to the limit, then will take advantage of me afterwards the people's identity will be asked him about the view on the woman.
"In fact the men all like the goodlooking woman, it is the most important to be though kindhearted, warm-hearted, but the man absolutely vision controls the animal of the brain " --Even arrived " Do not exceed the rule " Age last enticement,continue he say whether " but it is dream of to talk about by women ultimate, I think that have something to do with age. "
The fact is really like this, all of us know first love is incomparably bright, but can't almost repair into a right fruit, trace it to its cause to ascribe to the boy at that time and does not know what kind of woman oneself wants - -Even beautiful ugly standards are all ambiguous. Can be proved with an example: Classmates had a get-together a few days ago, I found it " the class spent " which we pursued that year Have good looks at all at all, so that reduce to to be married stage with ugliest girl into the class. The ones that can be seen we that year are aesthetic and ignorant.
As a man knew how to distinguish beautifully at last, but began to make mistakes on the outlook on life. Super male chauvinism person, think all OK if like, home environment, education background are not considered at all, then a lot of love tragedies were born when a pair of beautiful women got into the society. Can't shoulder living burden, is only full of departure of sad feelings in male chauvinism. Individual thinks often the injury that the man receives is greater on such a thing - -Having shouldered for a lot of years the heavy head will have been here agained, it is a very miserable thing to really get.
Remember a boss has said to me: "20 year old man have by nothing, but 20 -year-old girl there is any other things; 40 -year-old man have by everything, but 40 -year-old woman there is not any other things. " So he advise me spend energy on, strive for, have, have kind by everything by 40 year old, don't play with the emotion during 20 years old. So the meddler summarizes the following definition, according to the present state of development of society of our country, a man - -Plane inside except that son of vast wealth, look at the intersection of love and substantially as playing play-boy and other to regard marriage as the intersection of love and all sorts of man of terminal - -The target most suitable for the love is:
Woman earning one's own living - -The woman with independent economy generally has ability of good psychology and rational thinking;
Woman that the look is a bit more goodlooking than oneself - -So can meet the man's Vanity, but can't be much, otherwise the woman will think that marry losing, will bully you all one's life;
Aesthetic and unanimous woman - -If you like seeing the science fiction film, don't look for a woman liking seeing the literary film; If you like Wang Fei, don't look for a girl who likes Li Yapeng, though Wang Li two people have already got married!, that is not all right.
The above three are to give a man's suggestion of about 30 years old - -This is the best opportunity that a man discusses the wedding theory and marries, the woman who they looked for is probably about 25 years old, because according to analysing scientifically, men and women differ by 3 to 5 years old, can let men and women's facial old and feeble process reach unanimity, so on the issue to it is more slowly old than the woman not to present men, two people can settle down to enjoy " age together " Romance.
Say the scheme, man realize, stand up, still fill dangers about ultimate dream of woman, the older generation says that Hong Kong that location is cultural: "Can only look for the appropriate woman with a principle by today just like I, that ' who like I, who I like right away '. "
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Form and defend the project " The midwifery " Prevent and control the key tactics
Form and defend the project " The midwifery " Prevent and control the key tactics
It is reported (the intersection of reporter and Zheng dexterous) Lasts 8 years, covering the The World Bank Loan British grant Chinese tuberculosis control item of 670 million people in our country makes the outstanding achievement. This project not merely prevents and cures the exploration of the key policy to make and contribute tuberculosis of our country greatly, and reduced patient's death of 770,000 tuberculosis, has prevented 20 million healthy persons from being infected with tuberculosis fungus and 2 million persons and had illness coming on, 16 projects are saved to reduce the economic losses and is 4 billion at more least yuan every year. Yesterday, Ministry of Public Health, World Bank, British international development department held this project to summarize the conference in Beijing, cite advanced group and individual.
The tuberculosis control item was opened in March of 2002, it was our government that utilized the tenth hygiene loan project in the The World Bank Loan. This project adopts the brand-new financing mode of The World Bank Loan, British grant, regard improving the whole population especially health levels of people in the poverty-stricken area as the total goal, have covered Hebei, the Inner Mongol, Liaoning, Jilin, Fujian, Jiangxi, Henan, Hubei, Hunan, Guangxi, Chongqing, Guizhou, Yunnan, Shaanxi, Gansu, Xinjiang,etc. 16 province ( District, city) China 188 ground ( Market) 1450 piece county ( District) ,The total funds budget is up to 242 million dollars.
It is introduced project implementation this, the intersection of project and area find, treat 3,090,000 people, patient of active tuberculosis, together, among them the number of infective pulmonary tuberculosis patient is 1,840,000, accounts for national 52.5% which find the infective pulmonary tuberculosis patient in the same term. Every index of this project has already been realized as scheduled or ahead of time at present, the control strategy of modern tuberculosis (DOTS tactics) among them The coverage rate had already been up to 100% in 2005; Scribble newly open the intersection of patient and person who find up to 77.33%, than rise by 2 times in initial stage of project implementation; Remain above 90% all the time, has exceeded the goal to require to apply the cure rate of the open patient newly. Meanwhile, this project promoted a series of tuberculosis of our country to prevent and cure the new policy to issue and implement with the new tactics, for example will treat the policy and expand to and apply the overcast pulmonary tuberculosis patient free and make the health promotion strategy, initiate the material resources bank of health promotion, implement the poor patient and subsidize policy,etc..
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It is reported (the intersection of reporter and Zheng dexterous) Lasts 8 years, covering the The World Bank Loan British grant Chinese tuberculosis control item of 670 million people in our country makes the outstanding achievement. This project not merely prevents and cures the exploration of the key policy to make and contribute tuberculosis of our country greatly, and reduced patient's death of 770,000 tuberculosis, has prevented 20 million healthy persons from being infected with tuberculosis fungus and 2 million persons and had illness coming on, 16 projects are saved to reduce the economic losses and is 4 billion at more least yuan every year. Yesterday, Ministry of Public Health, World Bank, British international development department held this project to summarize the conference in Beijing, cite advanced group and individual.
The tuberculosis control item was opened in March of 2002, it was our government that utilized the tenth hygiene loan project in the The World Bank Loan. This project adopts the brand-new financing mode of The World Bank Loan, British grant, regard improving the whole population especially health levels of people in the poverty-stricken area as the total goal, have covered Hebei, the Inner Mongol, Liaoning, Jilin, Fujian, Jiangxi, Henan, Hubei, Hunan, Guangxi, Chongqing, Guizhou, Yunnan, Shaanxi, Gansu, Xinjiang,etc. 16 province ( District, city) China 188 ground ( Market) 1450 piece county ( District) ,The total funds budget is up to 242 million dollars.
It is introduced project implementation this, the intersection of project and area find, treat 3,090,000 people, patient of active tuberculosis, together, among them the number of infective pulmonary tuberculosis patient is 1,840,000, accounts for national 52.5% which find the infective pulmonary tuberculosis patient in the same term. Every index of this project has already been realized as scheduled or ahead of time at present, the control strategy of modern tuberculosis (DOTS tactics) among them The coverage rate had already been up to 100% in 2005; Scribble newly open the intersection of patient and person who find up to 77.33%, than rise by 2 times in initial stage of project implementation; Remain above 90% all the time, has exceeded the goal to require to apply the cure rate of the open patient newly. Meanwhile, this project promoted a series of tuberculosis of our country to prevent and cure the new policy to issue and implement with the new tactics, for example will treat the policy and expand to and apply the overcast pulmonary tuberculosis patient free and make the health promotion strategy, initiate the material resources bank of health promotion, implement the poor patient and subsidize policy,etc..
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Form and defend Sustainable development faces the challenge
Form and defend Sustainable development faces the challenge
It is reported (the intersection of reporter and Zheng dexterous) Recently, the The World Bank Loan British grant Chinese tuberculosis control item is announced and over. In the past 8 years, this biggest tuberculosis control item so far in the world, run into the areas of 670 million people of our country with a huge sum of money of more than 2 billion yuan, support to implement the control strategy of modern tuberculosis (DOTS tactics) . 16 provinces more ' District, city) 1450 county Districts, have included the most serious area of epidemic situation of tuberculosis of our country. After the project, the tuberculosis work of our country faces the challenge of sustainable development.
The reporter supervised the service centre to learn from fund of project of Ministry of Public Health a few days ago, utilize tenth hygiene loan project of The World Bank Loan as our government ' Abbreviated as and defended ten projects) ,This project is from designing to implementing, put sustainable development in the important position, and it is multiple to establish and guarantee the measure. Over the past 8 years, in the gross investment of this project, the governments at all levels of our country inject capital into and take more than half. Among them, the state revenue invests the funds from 4,640,000 yuan in 2002, rise to 176 million yuan in 2008, 733 million yuan of total input Damien among 2002 - 2008; Tuberculosis that offer prevent and cure funds total and reach 1,472 million yuan in the 8 year such as governments at all levels. It is introduced, during 8 years in project implementation, 50% of the project funds is used in the construction of hardware, 13% of the project funds is used in the professional team to train, has formed and prevented the sustainable development of the undertaking from laying a certain foundation for the project area.
China CDC ( Center for Disease Prevention and Control) Tuberculosis prevents the expert of control centre to brief on when being interviewed by reporter a few days ago, it is the low developed area of west of our country to defend the regional overwhelming majority that ten projects cover, including 474 national-level poor counties and 187 provincial poor counties. After project this finish, the intersection of tuberculosis and a great deal of challenges prevention and control face, area of project, need highly paying close attention to and replying promptly.
Challenge, continue implementing DOTS tactics and wait the governments at all levels promise. Survey and study, find defend after the ten project, the intersection of project and area plan, launch tuberculosis it prevents and cures basic work to be 630 million yuan in aggregate demand in annual funds by requirement according to country, funds shortage is 250 million yuan. If the local government can't well implement these funds, will influence the sustainable development of the project.
Challenge second of, implement, prevent the intersection of tuberculosis and tactics from face the difficulty. First of all, lack and contain the relevant policy of the tuberculosis tactics in an all-round way. The country has not been to the policy of making a diagnosis of charge free able to bear the medicine tuberculosis patient yet, have, set up, make a diagnosis tuberculosis expenses include medical treatment in, ensure long-efficiency development mechanism of system totally. Lack and succour the policy to the poor tuberculosis patient. Secondly, quantity of personnel of prophylactico-therapeutic institution and ability of existing tuberculosis still can't meet tuberculosis and prevent and cure the need. 200 milliamperes of X-ray machines and microscopes,etc. which the project units of most counties allocate in initial stage of still using the project, lack and infect the basic apparatus controlled, lack the ability that the system management is able to bear the medicine tuberculosis patient too.
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It is reported (the intersection of reporter and Zheng dexterous) Recently, the The World Bank Loan British grant Chinese tuberculosis control item is announced and over. In the past 8 years, this biggest tuberculosis control item so far in the world, run into the areas of 670 million people of our country with a huge sum of money of more than 2 billion yuan, support to implement the control strategy of modern tuberculosis (DOTS tactics) . 16 provinces more ' District, city) 1450 county Districts, have included the most serious area of epidemic situation of tuberculosis of our country. After the project, the tuberculosis work of our country faces the challenge of sustainable development.
The reporter supervised the service centre to learn from fund of project of Ministry of Public Health a few days ago, utilize tenth hygiene loan project of The World Bank Loan as our government ' Abbreviated as and defended ten projects) ,This project is from designing to implementing, put sustainable development in the important position, and it is multiple to establish and guarantee the measure. Over the past 8 years, in the gross investment of this project, the governments at all levels of our country inject capital into and take more than half. Among them, the state revenue invests the funds from 4,640,000 yuan in 2002, rise to 176 million yuan in 2008, 733 million yuan of total input Damien among 2002 - 2008; Tuberculosis that offer prevent and cure funds total and reach 1,472 million yuan in the 8 year such as governments at all levels. It is introduced, during 8 years in project implementation, 50% of the project funds is used in the construction of hardware, 13% of the project funds is used in the professional team to train, has formed and prevented the sustainable development of the undertaking from laying a certain foundation for the project area.
China CDC ( Center for Disease Prevention and Control) Tuberculosis prevents the expert of control centre to brief on when being interviewed by reporter a few days ago, it is the low developed area of west of our country to defend the regional overwhelming majority that ten projects cover, including 474 national-level poor counties and 187 provincial poor counties. After project this finish, the intersection of tuberculosis and a great deal of challenges prevention and control face, area of project, need highly paying close attention to and replying promptly.
Challenge, continue implementing DOTS tactics and wait the governments at all levels promise. Survey and study, find defend after the ten project, the intersection of project and area plan, launch tuberculosis it prevents and cures basic work to be 630 million yuan in aggregate demand in annual funds by requirement according to country, funds shortage is 250 million yuan. If the local government can't well implement these funds, will influence the sustainable development of the project.
Challenge second of, implement, prevent the intersection of tuberculosis and tactics from face the difficulty. First of all, lack and contain the relevant policy of the tuberculosis tactics in an all-round way. The country has not been to the policy of making a diagnosis of charge free able to bear the medicine tuberculosis patient yet, have, set up, make a diagnosis tuberculosis expenses include medical treatment in, ensure long-efficiency development mechanism of system totally. Lack and succour the policy to the poor tuberculosis patient. Secondly, quantity of personnel of prophylactico-therapeutic institution and ability of existing tuberculosis still can't meet tuberculosis and prevent and cure the need. 200 milliamperes of X-ray machines and microscopes,etc. which the project units of most counties allocate in initial stage of still using the project, lack and infect the basic apparatus controlled, lack the ability that the system management is able to bear the medicine tuberculosis patient too.
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Women's health care of nine kinds of youthful prescription _s given to 30 women
Women's health care of nine kinds of youthful prescription _s given to 30 women
The psychologist, nutritionist and psychotherapy expert have specially prepared the following suggestions for woman over 30 years old, you might as well have a try.
Point out one: Lighten the spiritual pressure
3 simple rules below can help you to lighten the daily spiritual pressure.
Breathe steadily: When acting on a momentary impulse, we can't help holding the breath, this will aggravate the spiritual pressure.
Correct the posture: Spiritual pressure will let the intersection of we and hunchback gradually, stretch quickly, seem to unload a group of the same heavy object from shoulder.
Standardize the behavior: Remember well even in nearly hopeless cases: You can change the present terrible situation, make it develop toward the good aspect.
Brief on two: Don't be eager to get up
Lie supine, spread the body first after waking up in the morning, then four limbs land, stretch and carry, reserve for the backbone " Revive " Time.
Brief on three: Take few lifts
Along the intersection of stair and more than 6 minutes up and down, can let you keep in high spirits in this way every day.
Brief on four: Pay attention to the posture of walking
While taking a walk in the family or park, stick out one's chest and go, this pair keeps bodily form very effective. If walk in this way at ordinary times, can consume heat of one time more.
Brief on five: Want sports every day
Jump, squat and stand, swing arm,etc. all around. Make movement these, contribute to, keep bodily form wholeheartedly every day, improve the blood circulation.
Brief on six: Tidy up the kitchen first after a meal
Finish, sit down or lie down, have a rest at once after a meal, can tidy up dining table, do the wash the intersection of bowl and dish first, do a little more other work. In a word, force oneself to move for 15 minutes after a meal.
Brief on seven: Don't sit for a long time
Make some simple gymnastics while watching TV. Work, don't call to come over from the other rooms colleague, but go over in person.
Brief on eight: Associate more
Good at less and half the probability more sick than unsociable and eccentric people of people of communication.
Brief on nine: Often smile
Smiling has strange results on strengthening the immune system, not only can consume heat, but also can regulate the mood.
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The psychologist, nutritionist and psychotherapy expert have specially prepared the following suggestions for woman over 30 years old, you might as well have a try.
Point out one: Lighten the spiritual pressure
3 simple rules below can help you to lighten the daily spiritual pressure.
Breathe steadily: When acting on a momentary impulse, we can't help holding the breath, this will aggravate the spiritual pressure.
Correct the posture: Spiritual pressure will let the intersection of we and hunchback gradually, stretch quickly, seem to unload a group of the same heavy object from shoulder.
Standardize the behavior: Remember well even in nearly hopeless cases: You can change the present terrible situation, make it develop toward the good aspect.
Brief on two: Don't be eager to get up
Lie supine, spread the body first after waking up in the morning, then four limbs land, stretch and carry, reserve for the backbone " Revive " Time.
Brief on three: Take few lifts
Along the intersection of stair and more than 6 minutes up and down, can let you keep in high spirits in this way every day.
Brief on four: Pay attention to the posture of walking
While taking a walk in the family or park, stick out one's chest and go, this pair keeps bodily form very effective. If walk in this way at ordinary times, can consume heat of one time more.
Brief on five: Want sports every day
Jump, squat and stand, swing arm,etc. all around. Make movement these, contribute to, keep bodily form wholeheartedly every day, improve the blood circulation.
Brief on six: Tidy up the kitchen first after a meal
Finish, sit down or lie down, have a rest at once after a meal, can tidy up dining table, do the wash the intersection of bowl and dish first, do a little more other work. In a word, force oneself to move for 15 minutes after a meal.
Brief on seven: Don't sit for a long time
Make some simple gymnastics while watching TV. Work, don't call to come over from the other rooms colleague, but go over in person.
Brief on eight: Associate more
Good at less and half the probability more sick than unsociable and eccentric people of people of communication.
Brief on nine: Often smile
Smiling has strange results on strengthening the immune system, not only can consume heat, but also can regulate the mood.
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Tubercle disease make a diagnosis standard _'s treatment
Tubercle disease make a diagnosis standard _'s treatment
Tubercle Definition: Tubercle (Sarcoidosis) Many systems that it is the unidentified reason are disorderly, its characteristic is immunoreaction of enhanced cell of sick position and the cheese a kind of granulation is swollen to exist. Diagnostic standard Corresponding clinic or chest X-ray indication It is not that a kind of granulation of cheese is swollen that histology is checked and shown The bacterium, fungi check negatively Except other granulation swelling disease Diagnose the step: X-ray HR-CT Lung function VC, FEV1, DLco ECG, UCG, myocardium phenomenon PPD tests, ACE, blood calcium, urine calcium, liver enzyme Eye inspection The fibrous bronchus mirror checks, lives by the bronchus wall lung and examines (TBLB) , the bronchus alveolus is irritated and washed (BAL) Acute tubercle (Lofgren' s syndrome) Characteristic ? Enlargement of lymph nodes of one pair of lungs door ? Arthritis ? Nodular erythema In addition often with generate heat and muscle ache, uncomfortable, 85% of the patients relieve in one year naturally Subnormal temperature chronic tubercle Symptom behaves: There is not symptom 45% Cough, have difficulty in breathing, uncomfortable in chest 30% The unable, weight is lightened, uncomfortable 10% Eyes, parotid gland, skin, peripheral enlargement of lymph nodes 15% What is not histology does not check and set up diagnosing is accorded with enough Lofgren' s syndrome Panda + Lambda (gallium scans) BAL: CD4/CD4>3.5 Histology does not check the dependability (clinical +X thread) diagnosed The tubercle I stage: 98% The tubercle II stage: 89% The tubercle III stage: 52% 0 issues tubercles: 13% Differential diagnosis: Malignant lymphoma, tuberculosis, bronchus lung cancer, the quality among other source anaphylactic alveolus inflammation or other lungs is ill, cancer lymphangitis The treatment is pointed out: ? Obvious symptom ? Serious or the going on function is damaged ? Does the chest slice show going on and ooze out and change? ? Behaving needs treating outside the lung: ? Heart (rhythm of the heart is not normal, the heart is depleted) ; Eyes; Nerve; Hypercalcemia disease, high calcium urine; The skin out of shape changes Regular treatment of of lung tubercle Begin the dosage: The intersection of prednisone and 20-40mg/day, 1-3Mon, according to react, appraise slowly decrement to 5-10 mg/day, keep June - December, park behind the medicine recuring 16-74%. Substitute the treatment: Sulphur thiazole purine Azathioprine 100-150mg/day First ammonia butterfly purine Methotrexate 10-25mg/w; Chloroquine Hydrochloroquine 400mg/day Indication of glucocorticoid with therapeutic part Iris inflammation grape and membrane inflammation Nasal polyp The bronchus is oozed out Other and complication treatment Song mould bronchiectasis: The operation excises, bronchus artery thromboembolism The bone is loosened disease: Vitamin D, calcium, lower calcium plainly Rehabilitation, oxygen are treated The lung is transplanted Natural course of disease Relieve 60-70% naturally Chronic going on 10-30% of course Involve 4-7% outside the serious lung 10-20% permanently Mortality is 1-5% (breath, centre, heart) Bad factor of the prognosis Lupus, chronic grape and membrane inflammation, 40 over the 40 Follow and observe The tubercle I stage: Every June; Other one: Every March - June; At least 3 years. In if X-ray normalization 2, needn't continue following!; The patient that relieves to the hormone treatment wants to strengthen and follow observing.
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Tubercle Definition: Tubercle (Sarcoidosis) Many systems that it is the unidentified reason are disorderly, its characteristic is immunoreaction of enhanced cell of sick position and the cheese a kind of granulation is swollen to exist. Diagnostic standard Corresponding clinic or chest X-ray indication It is not that a kind of granulation of cheese is swollen that histology is checked and shown The bacterium, fungi check negatively Except other granulation swelling disease Diagnose the step: X-ray HR-CT Lung function VC, FEV1, DLco ECG, UCG, myocardium phenomenon PPD tests, ACE, blood calcium, urine calcium, liver enzyme Eye inspection The fibrous bronchus mirror checks, lives by the bronchus wall lung and examines (TBLB) , the bronchus alveolus is irritated and washed (BAL) Acute tubercle (Lofgren' s syndrome) Characteristic ? Enlargement of lymph nodes of one pair of lungs door ? Arthritis ? Nodular erythema In addition often with generate heat and muscle ache, uncomfortable, 85% of the patients relieve in one year naturally Subnormal temperature chronic tubercle Symptom behaves: There is not symptom 45% Cough, have difficulty in breathing, uncomfortable in chest 30% The unable, weight is lightened, uncomfortable 10% Eyes, parotid gland, skin, peripheral enlargement of lymph nodes 15% What is not histology does not check and set up diagnosing is accorded with enough Lofgren' s syndrome Panda + Lambda (gallium scans) BAL: CD4/CD4>3.5 Histology does not check the dependability (clinical +X thread) diagnosed The tubercle I stage: 98% The tubercle II stage: 89% The tubercle III stage: 52% 0 issues tubercles: 13% Differential diagnosis: Malignant lymphoma, tuberculosis, bronchus lung cancer, the quality among other source anaphylactic alveolus inflammation or other lungs is ill, cancer lymphangitis The treatment is pointed out: ? Obvious symptom ? Serious or the going on function is damaged ? Does the chest slice show going on and ooze out and change? ? Behaving needs treating outside the lung: ? Heart (rhythm of the heart is not normal, the heart is depleted) ; Eyes; Nerve; Hypercalcemia disease, high calcium urine; The skin out of shape changes Regular treatment of of lung tubercle Begin the dosage: The intersection of prednisone and 20-40mg/day, 1-3Mon, according to react, appraise slowly decrement to 5-10 mg/day, keep June - December, park behind the medicine recuring 16-74%. Substitute the treatment: Sulphur thiazole purine Azathioprine 100-150mg/day First ammonia butterfly purine Methotrexate 10-25mg/w; Chloroquine Hydrochloroquine 400mg/day Indication of glucocorticoid with therapeutic part Iris inflammation grape and membrane inflammation Nasal polyp The bronchus is oozed out Other and complication treatment Song mould bronchiectasis: The operation excises, bronchus artery thromboembolism The bone is loosened disease: Vitamin D, calcium, lower calcium plainly Rehabilitation, oxygen are treated The lung is transplanted Natural course of disease Relieve 60-70% naturally Chronic going on 10-30% of course Involve 4-7% outside the serious lung 10-20% permanently Mortality is 1-5% (breath, centre, heart) Bad factor of the prognosis Lupus, chronic grape and membrane inflammation, 40 over the 40 Follow and observe The tubercle I stage: Every June; Other one: Every March - June; At least 3 years. In if X-ray normalization 2, needn't continue following!; The patient that relieves to the hormone treatment wants to strengthen and follow observing.
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Only wind for a love _ love time on desk
Only wind for a love _ love time on desk
They are colleagues, when she graduates from university and distributes into this unit, he has already worked here for two years. When see her at the first sight, he comes to like this gentle and quiet and beautiful girl. Then, later on he often looks for some excuses to be close to her, only
It is the time close at hand each time, he does not know how to explain to her.
In fact, she likes him very much too, the scene of staying with him that always appear at the moment while lying in bed silently in the evening. She thinks: So long as he says, will promise him without the least hesitation definitely by oneself. However, wish to wish to go, can not always wish he open one's mouth.
Until one day, he apparatus of kitchen it steals into piece to be empty, he afford to mutter and mumble. She promises very frankly, thinks: He should say this time.
The time that he comes off duty is very late, she finishes the meal and waits for him to come back to eat together early. He very move, it is good for a moment to gaze at her with tender feeling. Being very happy, she think he will show he can dodge retract own sight to some extent next, then bow head, take meal of oneself on the bowl very conscientiously. Dining table one small-scale desk all sides, they though relative holding, the distance is very near, she can even smell that kind of characterized man's flavor that he distributes out on one's body.
Perhaps because too small cause of dish used for dish, perhaps it is that because of In a word, when they insert dishes, two pairs of chopsticks often twine together, she thinks: When could they go to together? She waited for the arrival at that time whole-heartedly, but the distance between a small desk was so remote unexpectedly for him! It is good for a moment, does not see him act yet. What happened to this of mine? She, suddenly from wake in being infatuated, face red, cast a look at him affectionately, find he still in wipe out the meal on the bowl attentively. Her heart is getting cold in a moment.
She has eaten up the meal in oneself bowl quietly, then the head has not come into the room going back either. She hears him and calls one's own name, is full of in tone cannot help but with puzzledding, but she cares no more to turn round.
She finish supper early still later on, wait for him come back, wipe out together patient still. However, she no longer thirsts for his nearing. Later, she had a new boyfriend. She has been remembering all the time, that boy just known goes to another city by her, say to her candidly and boldly " I like you very much " And then, embrace her tightly.
Perhaps, can't hesitate in love, otherwise, can only cherish the memory of. A lot of years later, the light wind of cloud in all already is clear, they will still remember that section has seemed to already begin, say bright love never, remember that section shouldn't miss, wind always but one little love of desk.
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They are colleagues, when she graduates from university and distributes into this unit, he has already worked here for two years. When see her at the first sight, he comes to like this gentle and quiet and beautiful girl. Then, later on he often looks for some excuses to be close to her, only
It is the time close at hand each time, he does not know how to explain to her.
In fact, she likes him very much too, the scene of staying with him that always appear at the moment while lying in bed silently in the evening. She thinks: So long as he says, will promise him without the least hesitation definitely by oneself. However, wish to wish to go, can not always wish he open one's mouth.
Until one day, he apparatus of kitchen it steals into piece to be empty, he afford to mutter and mumble. She promises very frankly, thinks: He should say this time.
The time that he comes off duty is very late, she finishes the meal and waits for him to come back to eat together early. He very move, it is good for a moment to gaze at her with tender feeling. Being very happy, she think he will show he can dodge retract own sight to some extent next, then bow head, take meal of oneself on the bowl very conscientiously. Dining table one small-scale desk all sides, they though relative holding, the distance is very near, she can even smell that kind of characterized man's flavor that he distributes out on one's body.
Perhaps because too small cause of dish used for dish, perhaps it is that because of In a word, when they insert dishes, two pairs of chopsticks often twine together, she thinks: When could they go to together? She waited for the arrival at that time whole-heartedly, but the distance between a small desk was so remote unexpectedly for him! It is good for a moment, does not see him act yet. What happened to this of mine? She, suddenly from wake in being infatuated, face red, cast a look at him affectionately, find he still in wipe out the meal on the bowl attentively. Her heart is getting cold in a moment.
She has eaten up the meal in oneself bowl quietly, then the head has not come into the room going back either. She hears him and calls one's own name, is full of in tone cannot help but with puzzledding, but she cares no more to turn round.
She finish supper early still later on, wait for him come back, wipe out together patient still. However, she no longer thirsts for his nearing. Later, she had a new boyfriend. She has been remembering all the time, that boy just known goes to another city by her, say to her candidly and boldly " I like you very much " And then, embrace her tightly.
Perhaps, can't hesitate in love, otherwise, can only cherish the memory of. A lot of years later, the light wind of cloud in all already is clear, they will still remember that section has seemed to already begin, say bright love never, remember that section shouldn't miss, wind always but one little love of desk.
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Precise oil to get around mistaken idea maintain the intersection of attack strategy and the intersection of _ and 30 year old anti-aging embroidered purse
Precise oil to get around mistaken idea maintain the intersection of attack strategy and the intersection of _ and 30 year old anti-aging embroidered purse
The precise oil not only can protect the skin,but also can also recuperate spirit, thus reach the function that the body and mind releives. However, the use of the precise oil has all kinds of taboos, do you find out about? Come to have a look together quickly.
Correct the precise oil and use the mistaken idea
Precise volatility of oil very strong, once contact air, will volatilize quickly, turn on bottle, use, also cover it back to the shell as soon as possible. And then the editor will tell everybody that 8 pieces of smart oil use the mistaken idea, so long as avoid the mistaken idea, beautiful world where you can rest assured to enjoy the precise oil and bring!
Want to it takes to use the precise oil first correctly and understand it carefully, the precise oil is from the flower, leaf, stem, root or fruit of the plant, distill law, pinch law through vapor, cold to soak law or solvent draw law refine the fragrant material of volatility extracted.
Need to pay attention to, the precise oil is not diluted and you had better not generally be used directly. The volatility of the precise oil is very strong, once will volatilize quickly when contacting the air, because of this reason, precise oil must until can sealed bottle store, once turn on bottle, use, want, build, answer cover as soon as possible too.
And then the editor will tell everybody that 8 pieces of smart oil use the mistaken idea, so long as avoid the mistaken idea, beautiful world where you can rest assured to enjoy the precise oil and bring!
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The precise oil not only can protect the skin,but also can also recuperate spirit, thus reach the function that the body and mind releives. However, the use of the precise oil has all kinds of taboos, do you find out about? Come to have a look together quickly.
Correct the precise oil and use the mistaken idea
Precise volatility of oil very strong, once contact air, will volatilize quickly, turn on bottle, use, also cover it back to the shell as soon as possible. And then the editor will tell everybody that 8 pieces of smart oil use the mistaken idea, so long as avoid the mistaken idea, beautiful world where you can rest assured to enjoy the precise oil and bring!
Want to it takes to use the precise oil first correctly and understand it carefully, the precise oil is from the flower, leaf, stem, root or fruit of the plant, distill law, pinch law through vapor, cold to soak law or solvent draw law refine the fragrant material of volatility extracted.
Need to pay attention to, the precise oil is not diluted and you had better not generally be used directly. The volatility of the precise oil is very strong, once will volatilize quickly when contacting the air, because of this reason, precise oil must until can sealed bottle store, once turn on bottle, use, want, build, answer cover as soon as possible too.
And then the editor will tell everybody that 8 pieces of smart oil use the mistaken idea, so long as avoid the mistaken idea, beautiful world where you can rest assured to enjoy the precise oil and bring!
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Tubercle is diagnosed according to _'s symptom
Tubercle is diagnosed according to _'s symptom
Tubercle (sarcoidosis) It is the granulation swollen disease that a kind of multi system many organs are given much trouble. Infringe lung, dual the intersection of side and the intersection of lung and the intersection of door and lymph node, 90% of the above changes with lung at being clinical often, skin and pathological change of eyes secondly, shallow the intersection of table and lymph node, liver, spleen, kidney, bone marrow, nervous system, heart,etc. whole body can be given much trouble nearly. Disease this one limit disease, most good prognosis since, have the tendency to relieve naturally.
Tubercle is diagnosed and accorded with
1.It is swelling that the chest image learns to check and show one pair of sides lung door and mediastinal lymph node symmetry, accompany or not with the netted, tubercle or flaky shade in the lung.
2.Histology examine, verify, it has to be the intersection of the universe and the intersection of junket nature and necrosis swollen granulation while being living, resist acid, dye negative.
3.Serum angiotensin rises more than enzyme S A C E activity of melting.
4.Lie between in vain plainly serum or B A L F - 2 receptor (I L - 2 R) The level increases.
5.Old tuberculin (O T) Or it is negative or weak and positive to test P P D.
Lymphocyte count> 10, 4 C D C D 8 ratio gt in the 6 B A L F; =3 .
7.High blood calcium, high urine.
8.Kveim test positive.
9.Except swollen for disease in tuberculosis or others granulation.
In the above-mentioned 9, 1, 2, 8 is the major indicator, the others are secondary indexes.
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Tubercle (sarcoidosis) It is the granulation swollen disease that a kind of multi system many organs are given much trouble. Infringe lung, dual the intersection of side and the intersection of lung and the intersection of door and lymph node, 90% of the above changes with lung at being clinical often, skin and pathological change of eyes secondly, shallow the intersection of table and lymph node, liver, spleen, kidney, bone marrow, nervous system, heart,etc. whole body can be given much trouble nearly. Disease this one limit disease, most good prognosis since, have the tendency to relieve naturally.
Tubercle is diagnosed and accorded with
1.It is swelling that the chest image learns to check and show one pair of sides lung door and mediastinal lymph node symmetry, accompany or not with the netted, tubercle or flaky shade in the lung.
2.Histology examine, verify, it has to be the intersection of the universe and the intersection of junket nature and necrosis swollen granulation while being living, resist acid, dye negative.
3.Serum angiotensin rises more than enzyme S A C E activity of melting.
4.Lie between in vain plainly serum or B A L F - 2 receptor (I L - 2 R) The level increases.
5.Old tuberculin (O T) Or it is negative or weak and positive to test P P D.
Lymphocyte count> 10, 4 C D C D 8 ratio gt in the 6 B A L F; =3 .
7.High blood calcium, high urine.
8.Kveim test positive.
9.Except swollen for disease in tuberculosis or others granulation.
In the above-mentioned 9, 1, 2, 8 is the major indicator, the others are secondary indexes.
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Get around the sand and choose the mistaken idea of the idea three
Get around the sand and choose the mistaken idea of the idea three
Summary: Cement allocate a certain amount of sand only, turn body into, become cement can use behind the mortar. Some owners think, the more sand put is, the worse every performance of the mortar of cement is, actually this is not so. Send and decorate the whole introduction of engineering manager Qi Fu according to the dragon, based on different projects, the mix of the mortar of cement is different too in proportion, the brick employs allocating the proportion as 1 such as spreading along the side of the wall: The cement mortar of 1, make level and allocate the proportion dailily as 1 on the ground: 2 or 1: Cement mortar of 2.5.
The cement is divided into two kinds special cement and daily cement, the former marks high, the intensity is large, suitable for while stopping up and leaking, building the special project of pier,etc., the latter is different according to compositions, can be divided into 5 kinds portland cement, ordinary portland cement, slag cement, volcanic ash cement and fly ash cement, while home puts, use ordinary portland cement generally, in the industry to ask ordinary cement even.
According to different intensity, the ordinary cement is divided into a plurality of marking, usually mark the higher, the higher its intensity is, but it the less means it is the better high to mark, it is marked that different projects are applicable (intensity) Different cement. For example, paving if uses and marks the too high cement, may lead to the fact the ceramic tile appears in the hollowing while sticking the ceramic tile, even draw the phenomenon of splitting. Generally speaking, the usually applicable grade of the project is the cement of 32.5 in the family room.
Cement allocate a certain amount of sand only, turn body into, become cement can use behind the mortar. Some owners think, the more sand put is, the worse every performance of the mortar of cement is, actually this is not so. Send and decorate the whole introduction of engineering manager Qi Fu according to the dragon, based on different projects, the mix of the mortar of cement is different too in proportion, the brick employs allocating the proportion as 1 such as spreading along the side of the wall: The cement mortar of 1, make level and allocate the proportion dailily as 1 on the ground: 2 or 1: Cement mortar of 2.5.
In addition, some consumers often adopt the overdue cement in order to save money, the expert proposes that had better not behave like this. It is introduced, cement quality guarantee period is usually 3 months. 3 months later, though the cement can still be used, its intensity will be reduced greatly.
The family is everybody's dream, everybody's family has different styles, have a sincere one, there is a magnificent one, there is a brief one, no matter what kind of family it is, people pay attention to enjoying that relaxation that life bring at home even more now, unrestrained!Enjoy at home, please enter while sampling life:Channel of the houseThe editor recommends:Wonderful method of the mosquito that 29 die with rage
The editor recommends:The latest find The carcinogenic household articles expose completely
The editor recommends:The keyboard " kills virus " 5 wonderful methods
|
Summary: Cement allocate a certain amount of sand only, turn body into, become cement can use behind the mortar. Some owners think, the more sand put is, the worse every performance of the mortar of cement is, actually this is not so. Send and decorate the whole introduction of engineering manager Qi Fu according to the dragon, based on different projects, the mix of the mortar of cement is different too in proportion, the brick employs allocating the proportion as 1 such as spreading along the side of the wall: The cement mortar of 1, make level and allocate the proportion dailily as 1 on the ground: 2 or 1: Cement mortar of 2.5.
The cement is divided into two kinds special cement and daily cement, the former marks high, the intensity is large, suitable for while stopping up and leaking, building the special project of pier,etc., the latter is different according to compositions, can be divided into 5 kinds portland cement, ordinary portland cement, slag cement, volcanic ash cement and fly ash cement, while home puts, use ordinary portland cement generally, in the industry to ask ordinary cement even.
According to different intensity, the ordinary cement is divided into a plurality of marking, usually mark the higher, the higher its intensity is, but it the less means it is the better high to mark, it is marked that different projects are applicable (intensity) Different cement. For example, paving if uses and marks the too high cement, may lead to the fact the ceramic tile appears in the hollowing while sticking the ceramic tile, even draw the phenomenon of splitting. Generally speaking, the usually applicable grade of the project is the cement of 32.5 in the family room.
Cement allocate a certain amount of sand only, turn body into, become cement can use behind the mortar. Some owners think, the more sand put is, the worse every performance of the mortar of cement is, actually this is not so. Send and decorate the whole introduction of engineering manager Qi Fu according to the dragon, based on different projects, the mix of the mortar of cement is different too in proportion, the brick employs allocating the proportion as 1 such as spreading along the side of the wall: The cement mortar of 1, make level and allocate the proportion dailily as 1 on the ground: 2 or 1: Cement mortar of 2.5.
In addition, some consumers often adopt the overdue cement in order to save money, the expert proposes that had better not behave like this. It is introduced, cement quality guarantee period is usually 3 months. 3 months later, though the cement can still be used, its intensity will be reduced greatly.
The family is everybody's dream, everybody's family has different styles, have a sincere one, there is a magnificent one, there is a brief one, no matter what kind of family it is, people pay attention to enjoying that relaxation that life bring at home even more now, unrestrained!Enjoy at home, please enter while sampling life:Channel of the houseThe editor recommends:Wonderful method of the mosquito that 29 die with rage
The editor recommends:The latest find The carcinogenic household articles expose completely
The editor recommends:The keyboard " kills virus " 5 wonderful methods
|
Wednesday, January 30, 2013
Clinical manifestation _ symptom that the tubercle kidney damages
Clinical manifestation _ symptom that the tubercle kidney damages
1. Hypercalcemia disease and nephropathy
(1)Then sending hypercalcemia disease: Only accounts for 11%, poisoned with vitamin D similarly, the emergence of high blood calcium disease takes all patients' 10% - 20% .
(2)High calcium urine disease: Exceed hypercalcemia disease, it is 62%. High calcium is apt to cause kidney stone, 10% in the disease incidence of tubercle, it is that high blood calcium and high urine calcium acts on the inevitable result for a long time that the renal calcium is deposited, 5% incidence its, the intersection of tubercle and the intersection of disease and renal the intersection of calcium and the intersection of renal function and complete 50% incidence of person who deposit.
(3)The renal function is damaged: Resulted from hypercalcemia disease, in the tubercle patient who suffers from hypercalcemia disease, the intersection of serum and the intersection of skin and anhydride and direct relation of calcium, prove high the intersection of urine and calcium, the intersection of kidney and the intersection of calcium and deposit, kidney stone and the intersection of hypercalcemia and disease, can cause directly. Strain the glomerulus, reduce.
2. Granulation is swollen a quality nephritis Though is here 15% - 40% Tubercle disease the kidneys of patient in can see granulation being swollen,but only because granulation is swollen to soak to cause functions renal not to be failed, it is a kind of rare clinical phenomenon.
(1)Arteritis (have the intersection of tubercle and granulation swollen to soak disease) under kidney It may be a disease, rare complication.
(2)Vein soak can live examine, seeing in kidney while being even also in the kidney.
3. Swollen glomerulus nephritis of the granulation Reported in 1951, there were the reports of a lot of different tissue pathological glomerulus nephritises hereafter at first.
(1)Membrane nephropathy.
(2)Harden the office cooking stove glomerulus.
(3)The membrane increases glomerulus nephritis of natural disposition.
Not often complete with the renal function, kidney proteinuria, nephropathy and syndrome, hematuria and hypertension. This kind of deposition can also cause the manifestation of tubercles such as grape and membrane inflammation, arthralgia and skin,etc..
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1. Hypercalcemia disease and nephropathy
(1)Then sending hypercalcemia disease: Only accounts for 11%, poisoned with vitamin D similarly, the emergence of high blood calcium disease takes all patients' 10% - 20% .
(2)High calcium urine disease: Exceed hypercalcemia disease, it is 62%. High calcium is apt to cause kidney stone, 10% in the disease incidence of tubercle, it is that high blood calcium and high urine calcium acts on the inevitable result for a long time that the renal calcium is deposited, 5% incidence its, the intersection of tubercle and the intersection of disease and renal the intersection of calcium and the intersection of renal function and complete 50% incidence of person who deposit.
(3)The renal function is damaged: Resulted from hypercalcemia disease, in the tubercle patient who suffers from hypercalcemia disease, the intersection of serum and the intersection of skin and anhydride and direct relation of calcium, prove high the intersection of urine and calcium, the intersection of kidney and the intersection of calcium and deposit, kidney stone and the intersection of hypercalcemia and disease, can cause directly. Strain the glomerulus, reduce.
2. Granulation is swollen a quality nephritis Though is here 15% - 40% Tubercle disease the kidneys of patient in can see granulation being swollen,but only because granulation is swollen to soak to cause functions renal not to be failed, it is a kind of rare clinical phenomenon.
(1)Arteritis (have the intersection of tubercle and granulation swollen to soak disease) under kidney It may be a disease, rare complication.
(2)Vein soak can live examine, seeing in kidney while being even also in the kidney.
3. Swollen glomerulus nephritis of the granulation Reported in 1951, there were the reports of a lot of different tissue pathological glomerulus nephritises hereafter at first.
(1)Membrane nephropathy.
(2)Harden the office cooking stove glomerulus.
(3)The membrane increases glomerulus nephritis of natural disposition.
Not often complete with the renal function, kidney proteinuria, nephropathy and syndrome, hematuria and hypertension. This kind of deposition can also cause the manifestation of tubercles such as grape and membrane inflammation, arthralgia and skin,etc..
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Diagnostic method _'s symptom of tubercle
Diagnostic method _'s symptom of tubercle
The diagnosis of tubercle is except depending on medical history, X-ray, organize examining alive in main foundation or the Kveim's skin is tested.
1.Organize examining alive: ( 1) Draw materials from the simple table position at first, such as lymph node, rash, skin lower tubercle,etc., if the fat cushion lymph node of skin of oblique angle before being negative and desirable. ( 2) Fetch the mucous membrane of bronchus to live and examine under the fibrous bronchus mirror and fetch the lung and organize examining (TBLB) alive through the bronchus wall ,Many can obtain the positive result, especially chest X-ray 2 stage, a patient, the positive rate can be up to 63% one 97%.
2.Kveim experiment: Fetch active the intersection of tubercle and the intersection of disease and lymph node of patient or spleen do the antigen make brine to drift along, hang liquids, with the intersection of 0.1-0.2ml and the intersection of forearm and intradermal injection, excise this department skin after the 4- 8 week, competent pathology live, examine, the intersection of skin and kinds of the intersection of cell and tubercle get positive at the cheese such as show. The positive rate is about 65% one 92%. This experimental principle majority think that relate to cell immunity, may be in order to send a kind of type of hypersensitivity late.
3.Form and usually react: Tubercle cell immunity low at the disease, show as, form, react usually (5 old plain knot of unit) Negative or weak and positive. This law is one of the auxiliary diagnostic methods.
4.Invertase of angiotensin (Angiotension Converting Enzyme, ACE) : The blood vessel is changed tensely and plainly into angiotensin 2 with function of stepping up through ACE in lung capillary endothelial cells. Libermann finds the tubercle activity one, ACE increases in blood, there is certain help on the diagnosis of tubercle, especially judgement of the active state of pathological change.
5.The bronchus alveolus irritates lotion (BAL) Cytologic inspection: It is more sensitive than ACE that someone thinks BAL cytologic and checks to the diagnosis of tubercle and early alveolus inflammation and estimation of activity. It is shown as: The total number of cells increases; Lymphocytes increase (normal people account for 7% of the total number of cells, the tubercle patient can be up to 50%) ; T lymphocytes increase, can account for more than 28% of the total number of cells; It is auxiliary T lymphocyte /if you can't inhibit by T lymphocyte rate from, increase, be can rise to by l0.5/1 from 1.8/1.
6.67 gallium ( 67Ga) Scan: 67Ga assemble in the inflammation granulation swollen supersession activeness and hyperplasia strong area more, this may relate to the dissolving fungus enzyme and combining together and developing of neutral cells. The tubercle patient 67Ga index increases and becomes positive correlation with the total number of BAL lymphocytes, T lymphocyte number, quite helpful to the diagnosis of the inflammation intensity of alveolus, it is also the index of the activity of tubercle at the same time.
7.The active determination of peptide enzyme in the metal: The activity of tubercle patient this enzyme is higher than the control group by 3 times. The tubercle activity one is higher than non-activity by 2 times of one. And 4 times higher than the normal control group. Activity and control group of active tuberculosis, bronchus lung cancer, fiber case of the quality specially among the sending lung, this enzyme, do not have obvious difference. Explain the determination of this enzyme, there is certain help on diagnosis and activity one of tubercle.
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The diagnosis of tubercle is except depending on medical history, X-ray, organize examining alive in main foundation or the Kveim's skin is tested.
1.Organize examining alive: ( 1) Draw materials from the simple table position at first, such as lymph node, rash, skin lower tubercle,etc., if the fat cushion lymph node of skin of oblique angle before being negative and desirable. ( 2) Fetch the mucous membrane of bronchus to live and examine under the fibrous bronchus mirror and fetch the lung and organize examining (TBLB) alive through the bronchus wall ,Many can obtain the positive result, especially chest X-ray 2 stage, a patient, the positive rate can be up to 63% one 97%.
2.Kveim experiment: Fetch active the intersection of tubercle and the intersection of disease and lymph node of patient or spleen do the antigen make brine to drift along, hang liquids, with the intersection of 0.1-0.2ml and the intersection of forearm and intradermal injection, excise this department skin after the 4- 8 week, competent pathology live, examine, the intersection of skin and kinds of the intersection of cell and tubercle get positive at the cheese such as show. The positive rate is about 65% one 92%. This experimental principle majority think that relate to cell immunity, may be in order to send a kind of type of hypersensitivity late.
3.Form and usually react: Tubercle cell immunity low at the disease, show as, form, react usually (5 old plain knot of unit) Negative or weak and positive. This law is one of the auxiliary diagnostic methods.
4.Invertase of angiotensin (Angiotension Converting Enzyme, ACE) : The blood vessel is changed tensely and plainly into angiotensin 2 with function of stepping up through ACE in lung capillary endothelial cells. Libermann finds the tubercle activity one, ACE increases in blood, there is certain help on the diagnosis of tubercle, especially judgement of the active state of pathological change.
5.The bronchus alveolus irritates lotion (BAL) Cytologic inspection: It is more sensitive than ACE that someone thinks BAL cytologic and checks to the diagnosis of tubercle and early alveolus inflammation and estimation of activity. It is shown as: The total number of cells increases; Lymphocytes increase (normal people account for 7% of the total number of cells, the tubercle patient can be up to 50%) ; T lymphocytes increase, can account for more than 28% of the total number of cells; It is auxiliary T lymphocyte /if you can't inhibit by T lymphocyte rate from, increase, be can rise to by l0.5/1 from 1.8/1.
6.67 gallium ( 67Ga) Scan: 67Ga assemble in the inflammation granulation swollen supersession activeness and hyperplasia strong area more, this may relate to the dissolving fungus enzyme and combining together and developing of neutral cells. The tubercle patient 67Ga index increases and becomes positive correlation with the total number of BAL lymphocytes, T lymphocyte number, quite helpful to the diagnosis of the inflammation intensity of alveolus, it is also the index of the activity of tubercle at the same time.
7.The active determination of peptide enzyme in the metal: The activity of tubercle patient this enzyme is higher than the control group by 3 times. The tubercle activity one is higher than non-activity by 2 times of one. And 4 times higher than the normal control group. Activity and control group of active tuberculosis, bronchus lung cancer, fiber case of the quality specially among the sending lung, this enzyme, do not have obvious difference. Explain the determination of this enzyme, there is certain help on diagnosis and activity one of tubercle.
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The tubercle kidney damages and treats _'s treatment of the principle
The tubercle kidney damages and treats _'s treatment of the principle
The patient that some tubercle kidneys damage can relieve by oneself.
1.Glucocorticoid: Suitable for tubercle and pathological change and develop one, blood calcium, urine calcium increases, obvious raised patient of the angiotensin content of serum.
( 1) Employ the intersection of cortical hormone and the intersection of treatment and disease this continue quality nephritis among the take place, can make the patient's renal function improve rapidly.
( 2) Quality nephritis response therapeutic to cortical hormone dramatic often among the getting swollen granulation, the renal function is not complete and the renal tubule is unusual and can be improved, but there are persons who aggravate after treating.
2.Other immune inhibitors and malicious medicines of cell are only used in the case of glucocorticoid with not good enough therapeutic effect.
3.Forbid vitamin D, wait for, can cause blood calcium, the intersection of urine and medicine that calcium increased.
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The patient that some tubercle kidneys damage can relieve by oneself.
1.Glucocorticoid: Suitable for tubercle and pathological change and develop one, blood calcium, urine calcium increases, obvious raised patient of the angiotensin content of serum.
( 1) Employ the intersection of cortical hormone and the intersection of treatment and disease this continue quality nephritis among the take place, can make the patient's renal function improve rapidly.
( 2) Quality nephritis response therapeutic to cortical hormone dramatic often among the getting swollen granulation, the renal function is not complete and the renal tubule is unusual and can be improved, but there are persons who aggravate after treating.
2.Other immune inhibitors and malicious medicines of cell are only used in the case of glucocorticoid with not good enough therapeutic effect.
3.Forbid vitamin D, wait for, can cause blood calcium, the intersection of urine and medicine that calcium increased.
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The diagnosis of tubercle and _'s symptom of the differential diagnosis
The diagnosis of tubercle and _'s symptom of the differential diagnosis
[Diagnose ]
The diagnosis of tubercle is decided by clinical symptom and physical sign and organizes examining alive, other granulation swollen diseases except combining. Its diagnostic standard is summed up: It is symmetrical and swelling that the chest image learns to check and reveal one pair of sides lung door and mediastinal lymph node, accompany or not with the grid, tubercle or flaky shade in the lung; Histology examine, verify, it has to be the intersection of cheese nature and necrosis swollen granulation while being living, resist acid, dye negative; SACE or SL activity increases; It is sIL-2r high in serum or BALF; Old tuberculin (OT) Or PPD tests the masculine gender or weak and positive; Lymphocyte under BALF> 10%, and CD4 + CD8 + ratio is greater than or equal to 3; High blood calcium, high urine; Kveim tests the masculine gender; Except tuberculosis or others is swollen in granulation for disease. In the above-mentioned nine conditions, It is the essential condition, the others are secondary conditions.
[Differential diagnosis ]
Should distinguish with the following diseases:
First, lung door scrofula
Have younger patients and how under 20 years oldly, have the intersection of minuent and toxic symptom, more for being positive tuberculin test often, the enlargement of lymph nodes of lung door is generally single side, the calcification sometimes. It is obvious the lung has illness coming on in the cooking stove originally.
Second, lymphoma
Common all over symptom is generating heat, becoming thin, anaemia,etc., the pleura is given much trouble, present the thorax and accumulate the liquid, the lymph node is swollen mostly single side or dual sides are asymmetric and swelling in the chest, it is mediastinal to often involve, the eminence plays and mediastinal lymph node. Mediastinal press and can present the superior vena cava and block syndrome. Combining other checking and biopsies can be distinguished.
Third, lung door shifting tumour
The transformation of cancerous swelling all has corresponding symptom and physical sign to the lung door lymph node outside lung cancer and lung, further check and can help and distinguish suspicious sending the cooking stove originally.
Fourth, other granulation swollen diseases
Such as other source alveolus inflammation, beryllium disease, pneumosilicosis, infection, chemical granulation due to the factors being swollen, should distinguish with tubercle, combine the clinical materials and have something to do with and check to analyse and judge synthetically.
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[Diagnose ]
The diagnosis of tubercle is decided by clinical symptom and physical sign and organizes examining alive, other granulation swollen diseases except combining. Its diagnostic standard is summed up: It is symmetrical and swelling that the chest image learns to check and reveal one pair of sides lung door and mediastinal lymph node, accompany or not with the grid, tubercle or flaky shade in the lung; Histology examine, verify, it has to be the intersection of cheese nature and necrosis swollen granulation while being living, resist acid, dye negative; SACE or SL activity increases; It is sIL-2r high in serum or BALF; Old tuberculin (OT) Or PPD tests the masculine gender or weak and positive; Lymphocyte under BALF> 10%, and CD4 + CD8 + ratio is greater than or equal to 3; High blood calcium, high urine; Kveim tests the masculine gender; Except tuberculosis or others is swollen in granulation for disease. In the above-mentioned nine conditions, It is the essential condition, the others are secondary conditions.
[Differential diagnosis ]
Should distinguish with the following diseases:
First, lung door scrofula
Have younger patients and how under 20 years oldly, have the intersection of minuent and toxic symptom, more for being positive tuberculin test often, the enlargement of lymph nodes of lung door is generally single side, the calcification sometimes. It is obvious the lung has illness coming on in the cooking stove originally.
Second, lymphoma
Common all over symptom is generating heat, becoming thin, anaemia,etc., the pleura is given much trouble, present the thorax and accumulate the liquid, the lymph node is swollen mostly single side or dual sides are asymmetric and swelling in the chest, it is mediastinal to often involve, the eminence plays and mediastinal lymph node. Mediastinal press and can present the superior vena cava and block syndrome. Combining other checking and biopsies can be distinguished.
Third, lung door shifting tumour
The transformation of cancerous swelling all has corresponding symptom and physical sign to the lung door lymph node outside lung cancer and lung, further check and can help and distinguish suspicious sending the cooking stove originally.
Fourth, other granulation swollen diseases
Such as other source alveolus inflammation, beryllium disease, pneumosilicosis, infection, chemical granulation due to the factors being swollen, should distinguish with tubercle, combine the clinical materials and have something to do with and check to analyse and judge synthetically.
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The prognosis of tubercle prevents _'s prevention and health care
The prognosis of tubercle prevents _'s prevention and health care
Tubercle (sarcoidosis) It is the granulation swollen disease that a kind of multi system many organs are given much trouble. Infringe lung, dual the intersection of side and the intersection of lung and the intersection of door and lymph node, 90% of the above changes with lung at being clinical often, skin and pathological change of eyes secondly, shallow the intersection of table and lymph node, liver, spleen, kidney, bone marrow, nervous system, heart,etc. whole body can be given much trouble nearly. Disease this one limit disease, most good prognosis since, have the tendency to relieve naturally.
The prognosis relates to condition of tubercle. Acute to blow patient, through treat or relieve by oneself, prognosis better; And chronic going on, infringe a plurality of organs, cause the function to damage, the extensive fiber of lung, it is infected with after in advance worse or acute. The death reason is often infringed for lung original heart disease or cardiac muscle, brain. Have the intersection of report and 34% the intersection of case and full restoration follow up a case by regular visits to every 5 years, 30% improve, 20% change, condition worsen and die, account for 8% respectively.
Prevent general knowledge: The patient should strengthen and treat the confidence and patience first, most of this diseases can be through treating or relieving naturally, but its reinsertion process often takes several years. Should pay attention to protecting eyes, skin, joint, in case the damage of this position is aggravated; Prevent the airway infection, can lighten the damage of the lung.
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Tubercle (sarcoidosis) It is the granulation swollen disease that a kind of multi system many organs are given much trouble. Infringe lung, dual the intersection of side and the intersection of lung and the intersection of door and lymph node, 90% of the above changes with lung at being clinical often, skin and pathological change of eyes secondly, shallow the intersection of table and lymph node, liver, spleen, kidney, bone marrow, nervous system, heart,etc. whole body can be given much trouble nearly. Disease this one limit disease, most good prognosis since, have the tendency to relieve naturally.
The prognosis relates to condition of tubercle. Acute to blow patient, through treat or relieve by oneself, prognosis better; And chronic going on, infringe a plurality of organs, cause the function to damage, the extensive fiber of lung, it is infected with after in advance worse or acute. The death reason is often infringed for lung original heart disease or cardiac muscle, brain. Have the intersection of report and 34% the intersection of case and full restoration follow up a case by regular visits to every 5 years, 30% improve, 20% change, condition worsen and die, account for 8% respectively.
Prevent general knowledge: The patient should strengthen and treat the confidence and patience first, most of this diseases can be through treating or relieving naturally, but its reinsertion process often takes several years. Should pay attention to protecting eyes, skin, joint, in case the damage of this position is aggravated; Prevent the airway infection, can lighten the damage of the lung.
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Brief introduction of _'s treatment of vitamin D of taboo medicine of of tubercle
Brief introduction of _'s treatment of vitamin D of taboo medicine of of tubercle
Vitamin D is firm alcohol derivative, resist rickets function, are also called and resisted rickets vitamin. The most important member is D2 and D3 in vitamin D family members. Vitamin D is different vitamin D derivative after purple to shine outside originallies. The plant does not include vitamin D, but vitamin D exists in aninals or plants' body originally. Ergota alcohol in the plant is original for vitamin D2, can change into vitamin D2 after purple to shine outside, have another name called Ergota calciferol; People and 7 included under the skin of animal - take off hydrogen cholesterol original for vitamin D3, change into vitamin D3 after purple to shine outside, have another name called calciferol of gallbladder. Vitamin D2 Molecule type C28H44O vitamin D3 molecule type C27H44O
Vitamin D it contributes to be through promote calcium absorb then regulate many kinds of physiological functions mainly in body. Research prove the intersection of vitamin and D3 can induce a lot of the intersection of intestines and mucous membrane of animal produce one single-minded calcium get married albumen (CaBP) ,The ones that increase animal's enteric mucous membrane to calcium ion are penetrating, promote calcium in the enteric absorption inside.
The main function of vitamin D is to regulate internal calcium, phosphorus supersession, keep the level of blood calcium and blood phosphorus, thus develop once keeping the normal growth of teeth and the skeleton. Children lack vitamin D, rickets incident, taking vitamin D will cause acute poisoning too much. Vitamin D is a kind of lipid-soluble vitamin, there are five kinds of compounds, it is vitamin D2 and vitamin D3 to that the health relation is closer. They have three following characteristics: It exists in some natural food; After being shone by the ultraviolet one, cholesterol in the human body can be turned into vitamin D.
First, main physiological function of vitamin D
Vitamin D mainly has the following physiological functions: 1,Improve human body's absorption of calcium, phosphorus, make the level of blood plasma calcium and blood plasma phosphorus reach, saturate the intensity. 2,Promote growth and skeleton calcification, promote teeth to be sound; 3,Increase the absorption of phosphorus through the enteric wall, and increase the absorption of phosphorus through the renal tubule; 4,Keep the normal level of citrate in the blood; 5,Prevent amino acid from passing renal losses.
Second, vitamin D is full of lacking to healthy influence
Vitamin D is excessive to behave Some scholars think that it can be caused and poisoned to take in 25 g vitamin D long-term every day, may include some persons more sensitive to vitamin D among them, but it is certain to cause to be poisoned to take in 125 g vitamin D long-term every day. Symptom poisoned is unusually thirsty, eyes inflammation, the skin tickles, apocleisis, having a liking for sleeping, vomits, diarrhoea, polyuria and unusual sediment in the blood vessel wall, liver, lung, kidney, stomach of calcium, the joint pains with the filling the air osseously and takes off ores. It is 20 g that our country can tolerate the supreme intaking amount to make vitamin D.Deficiency disease of vitamin DRickets, serious dental caries, richets, senile osteoporosis.
Need crowds 1,The person in city, especially the people in the region that the dense smoke pollutes should absorb more vitamin D. 2,Night worker, nun, because of the clothes, life style can't get people of sunshine, want, pay special attention to, increase uptake of vitamin D in diet fully. 3,If you are taking the medicine against convulsion, must increase the uptake of vitamin D. 4,Drink the uptake amount that the child not adding milk of vitamin D must increase vitamin D. 5,The blacker in boreal climate region people of skin color need more vitamin D.
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Vitamin D is firm alcohol derivative, resist rickets function, are also called and resisted rickets vitamin. The most important member is D2 and D3 in vitamin D family members. Vitamin D is different vitamin D derivative after purple to shine outside originallies. The plant does not include vitamin D, but vitamin D exists in aninals or plants' body originally. Ergota alcohol in the plant is original for vitamin D2, can change into vitamin D2 after purple to shine outside, have another name called Ergota calciferol; People and 7 included under the skin of animal - take off hydrogen cholesterol original for vitamin D3, change into vitamin D3 after purple to shine outside, have another name called calciferol of gallbladder. Vitamin D2 Molecule type C28H44O vitamin D3 molecule type C27H44O
Vitamin D it contributes to be through promote calcium absorb then regulate many kinds of physiological functions mainly in body. Research prove the intersection of vitamin and D3 can induce a lot of the intersection of intestines and mucous membrane of animal produce one single-minded calcium get married albumen (CaBP) ,The ones that increase animal's enteric mucous membrane to calcium ion are penetrating, promote calcium in the enteric absorption inside.
The main function of vitamin D is to regulate internal calcium, phosphorus supersession, keep the level of blood calcium and blood phosphorus, thus develop once keeping the normal growth of teeth and the skeleton. Children lack vitamin D, rickets incident, taking vitamin D will cause acute poisoning too much. Vitamin D is a kind of lipid-soluble vitamin, there are five kinds of compounds, it is vitamin D2 and vitamin D3 to that the health relation is closer. They have three following characteristics: It exists in some natural food; After being shone by the ultraviolet one, cholesterol in the human body can be turned into vitamin D.
First, main physiological function of vitamin D
Vitamin D mainly has the following physiological functions: 1,Improve human body's absorption of calcium, phosphorus, make the level of blood plasma calcium and blood plasma phosphorus reach, saturate the intensity. 2,Promote growth and skeleton calcification, promote teeth to be sound; 3,Increase the absorption of phosphorus through the enteric wall, and increase the absorption of phosphorus through the renal tubule; 4,Keep the normal level of citrate in the blood; 5,Prevent amino acid from passing renal losses.
Second, vitamin D is full of lacking to healthy influence
Vitamin D is excessive to behave Some scholars think that it can be caused and poisoned to take in 25 g vitamin D long-term every day, may include some persons more sensitive to vitamin D among them, but it is certain to cause to be poisoned to take in 125 g vitamin D long-term every day. Symptom poisoned is unusually thirsty, eyes inflammation, the skin tickles, apocleisis, having a liking for sleeping, vomits, diarrhoea, polyuria and unusual sediment in the blood vessel wall, liver, lung, kidney, stomach of calcium, the joint pains with the filling the air osseously and takes off ores. It is 20 g that our country can tolerate the supreme intaking amount to make vitamin D.Deficiency disease of vitamin DRickets, serious dental caries, richets, senile osteoporosis.
Need crowds 1,The person in city, especially the people in the region that the dense smoke pollutes should absorb more vitamin D. 2,Night worker, nun, because of the clothes, life style can't get people of sunshine, want, pay special attention to, increase uptake of vitamin D in diet fully. 3,If you are taking the medicine against convulsion, must increase the uptake of vitamin D. 4,Drink the uptake amount that the child not adding milk of vitamin D must increase vitamin D. 5,The blacker in boreal climate region people of skin color need more vitamin D.
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Check _'s treatment in diagnosis of tubercle
Check _'s treatment in diagnosis of tubercle
Diagnose:The active judgement of of tubercle: Whether tubercle is moved and used mainly in confirming whether swollen inflammation of the granulation is going on; Not big to determining whether to treat the meaning or not. If the organ function is fair, there is not symptom or slight granulation swollen inflammation that is uncertain the need is treated. At present, the therapeutic determination based on repeated clinical examination and organ function of decision. Clinical manifestation can help to judge the disease activity, but not accurate enough. Image study, contribute to, find out about activity of disease with the intersection of lung and change of function. The lymphocyte percentage that someone recommends irritating lotion through determining the bronchus alveolus reflects lung essence inflammation; The percentage of lymphocytes rises and points out " The high strength " Alveolus inflammation. 67Ga lung scans and can reflect inflammation, but still need studying to fix through being more extensive and prospective. Raise being swollen in granulation sACE or at skin kinds of cell outgrowth result,determine whether sACE be can use for not lasting disease activitied level, but its dependability has not been fully verified yet. In a word, the active determination of of tubercle mainly includes determination of sACE, 67Ga scan and irritate the inspection of lotion with the bronchus alveolus.
Check in the laboratory:The blood routine is not unusual more, but there is anaemia occasionally. Activity issues of blood intermediate to reduce in lymphocyte for around blood like being with high uncertainty. Having a liking for acid cells can increase temporarily. The accidental blood platelet reduces and purpura. Erythrocyte sedimentation rate can be accelerated; 2%- 10% amalgamate hypercalcemia disease and high urine. The immunoglobulin (Ig) density generally increases, IgM, IgA and IgG raise, the black person exceeds the white man. A few cases of C - response albumen can increase. Pathological change invade and skeleton, and at the liver, alkaline phosphatase can rise.
Other auxiliary examination:The chest is usually normal in physical examination ' But it is unusually extensive that the X-ray may exist) . Besides Lofgren's syndrome, have not usually generated heat. Other positive physical sign swollen or fiber take have something to do with in granulation of system with special organ more. For instance, skin lower tubercles or muscle tubercles. The crack light may find eye pathological change to check. Palpation can and intermediate to increase liver splenomegaly in lymph node. It is out of shape to brief skeleton on pathological change for toe to mean, the chronic case can demonstrate that point (toe) First lacks nutrition. In addition, there may also be physical sign of acute arthritis.
1.Perspect, check CT in chest check chest slice to find main means, tubercle of disease in the chest while being ordinary, mainly shown in the following several aspects:
The enlargement of lymph nodes in the chest: Including the lung door, mediastinal enlargement of lymph nodes. The enlargement of lymph nodes of lung door regards symmetry of both sides as the characteristic, accounts for 90%- 95%, only enlargement of lymph nodes person only accounts for 1%- 3% on one side lung door. It is generally relatively obvious on the left side that the right side lung door is swelling. The enlargement of lymph nodes of many groups is its characteristic. Every lymph node that increase can size close, can also stress so as to a group of lymphadenovaris. The swelling lymph node realm is clear, the density is even, take the form of round or potato. Enlargement of lymph nodes it is mediastinal in after before on location slice, show as whether increase wide one side or dual side shades mediastinal, nearly have half the number case with the enlargement of lymph nodes by the trachea in right. The lymph most often infringed becomes the mediastinal and aorta window lymph node in dual side lungs door, right.
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Diagnose:The active judgement of of tubercle: Whether tubercle is moved and used mainly in confirming whether swollen inflammation of the granulation is going on; Not big to determining whether to treat the meaning or not. If the organ function is fair, there is not symptom or slight granulation swollen inflammation that is uncertain the need is treated. At present, the therapeutic determination based on repeated clinical examination and organ function of decision. Clinical manifestation can help to judge the disease activity, but not accurate enough. Image study, contribute to, find out about activity of disease with the intersection of lung and change of function. The lymphocyte percentage that someone recommends irritating lotion through determining the bronchus alveolus reflects lung essence inflammation; The percentage of lymphocytes rises and points out " The high strength " Alveolus inflammation. 67Ga lung scans and can reflect inflammation, but still need studying to fix through being more extensive and prospective. Raise being swollen in granulation sACE or at skin kinds of cell outgrowth result,determine whether sACE be can use for not lasting disease activitied level, but its dependability has not been fully verified yet. In a word, the active determination of of tubercle mainly includes determination of sACE, 67Ga scan and irritate the inspection of lotion with the bronchus alveolus.
Check in the laboratory:The blood routine is not unusual more, but there is anaemia occasionally. Activity issues of blood intermediate to reduce in lymphocyte for around blood like being with high uncertainty. Having a liking for acid cells can increase temporarily. The accidental blood platelet reduces and purpura. Erythrocyte sedimentation rate can be accelerated; 2%- 10% amalgamate hypercalcemia disease and high urine. The immunoglobulin (Ig) density generally increases, IgM, IgA and IgG raise, the black person exceeds the white man. A few cases of C - response albumen can increase. Pathological change invade and skeleton, and at the liver, alkaline phosphatase can rise.
Other auxiliary examination:The chest is usually normal in physical examination ' But it is unusually extensive that the X-ray may exist) . Besides Lofgren's syndrome, have not usually generated heat. Other positive physical sign swollen or fiber take have something to do with in granulation of system with special organ more. For instance, skin lower tubercles or muscle tubercles. The crack light may find eye pathological change to check. Palpation can and intermediate to increase liver splenomegaly in lymph node. It is out of shape to brief skeleton on pathological change for toe to mean, the chronic case can demonstrate that point (toe) First lacks nutrition. In addition, there may also be physical sign of acute arthritis.
1.Perspect, check CT in chest check chest slice to find main means, tubercle of disease in the chest while being ordinary, mainly shown in the following several aspects:
The enlargement of lymph nodes in the chest: Including the lung door, mediastinal enlargement of lymph nodes. The enlargement of lymph nodes of lung door regards symmetry of both sides as the characteristic, accounts for 90%- 95%, only enlargement of lymph nodes person only accounts for 1%- 3% on one side lung door. It is generally relatively obvious on the left side that the right side lung door is swelling. The enlargement of lymph nodes of many groups is its characteristic. Every lymph node that increase can size close, can also stress so as to a group of lymphadenovaris. The swelling lymph node realm is clear, the density is even, take the form of round or potato. Enlargement of lymph nodes it is mediastinal in after before on location slice, show as whether increase wide one side or dual side shades mediastinal, nearly have half the number case with the enlargement of lymph nodes by the trachea in right. The lymph most often infringed becomes the mediastinal and aorta window lymph node in dual side lungs door, right.
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's general knowledge of diagnostic standard of tubercle
's general knowledge of diagnostic standard of tubercle
Diagnose: The diagnosis of tubercle is decided by clinical symptom and physical sign and organizes examining alive, other granulation swollen diseases except combining. Its diagnostic standard is summed up: It is symmetrical and swelling that the chest image learns to check and reveal one pair of sides lung door and mediastinal lymph node, accompany or not with the grid, tubercle or flaky shade in the lung; Histology examine, verify, it has to be the intersection of cheese nature and necrosis swollen granulation while being living, resist acid, dye negative; SACE or SL activity increases; It is sIL-2R high in serum or BALF; Old tuberculin (OT) Or PPD tests the masculine gender or weak and positive; Lymphocyte under BALF> 10%, and CD4 + CD8 + ratio is greater than or equal to 3; High blood calcium, high urine; Kveim tests the masculine gender; Except tuberculosis or others is swollen in granulation for disease. In the above-mentioned nine conditions, It is the essential condition, the others are secondary conditions.
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Diagnose: The diagnosis of tubercle is decided by clinical symptom and physical sign and organizes examining alive, other granulation swollen diseases except combining. Its diagnostic standard is summed up: It is symmetrical and swelling that the chest image learns to check and reveal one pair of sides lung door and mediastinal lymph node, accompany or not with the grid, tubercle or flaky shade in the lung; Histology examine, verify, it has to be the intersection of cheese nature and necrosis swollen granulation while being living, resist acid, dye negative; SACE or SL activity increases; It is sIL-2R high in serum or BALF; Old tuberculin (OT) Or PPD tests the masculine gender or weak and positive; Lymphocyte under BALF> 10%, and CD4 + CD8 + ratio is greater than or equal to 3; High blood calcium, high urine; Kveim tests the masculine gender; Except tuberculosis or others is swollen in granulation for disease. In the above-mentioned nine conditions, It is the essential condition, the others are secondary conditions.
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Tuesday, January 29, 2013
The therapeutic _'s treatment of tubercle
The therapeutic _'s treatment of tubercle
The therapeutic adaptation card of glucocorticoid of tubercle still has objection, to some slight cases, for instance skin damage, before grape membrane inflammation or cough,etc.,only need cortical hormones some not to be treated, whole body tubercle usually needs oral cortical hormone, heart and nervous system pathological change, high blood calcium and eye pathological change failing to respond to any medical treatment to the part are the therapeutic adaptation card of oral cortical hormone. The the whole body cortical hormone treatment of tubercle still have objection outside lung and other lungs, but most scholars should consider the cortical hormone treatment of whole body while thinking that there are symptom and going on development. Have symptom but have continuation lung soak or person who go on the intersection of lung and function too should consider the intersection of whole body and the intersection of and the intersection of cortical hormone and treatment lose. To needing the patient that long-term cortical hormone treats, should consider resisting the use of malaria medicine and malicious medicine of cell, can consider implementing the lung and transplanting the skill while being few to cure venereal disease example while being difficult.
1.Glucocorticoid
Early research shows, short-term oral cortical hormone can relieve respiratory tract symptom, improve the intersection of lung and soak and the intersection of lung and function that X-ray reveal, repeat, examine, reveal cortisone over a longer period treat, can make granulation to be swollen to relieve too while being alive. But stop, treat, often can cause symptom and lung soak recur, have report in stop, treat how patient more than 1/3 recurs in the 2 year.
Therapeutic suitable dosage and course of treatment about cortical hormone are still scarce to seek unity of standard, but in conformity with the individual. To lung tubercle, the initial dosage is usually to splash the Buddhist nun loose for 20- 40mg every other day (prednisone) Or equivalent other cortical hormone, the heart or nervous system pathological change should increase the dosage appropriately, 1- should assess curative effect after the 3 month, treat through 3 month still getting invalid even lengthen time can effective either, should look for reason failed to treat, such as irreversibility fiber take and dosage enough for and endogenous sex hormone tolerate, hormone should from decrement to every day or 5- 10mg every other day, should treat at least 12 month continuously gradually when being treatment effective, cortical hormone decrement or stop after should pay attention to not recuring,because if you can't recur, need not keeping not treating low dose ofly for a long time repeatedly to some patient.
Tubercle skin damage, iris inflammation, grape and membrane inflammation, nasal polyp or angry way pathological change can be treated with some cortical hormone, lung tubercle can be adopted and sucked cortical hormone too.
2.Malicious medicine of cell
The malicious medicine of cell has already verified that there is precise clinical curative effect among some patients, among them first ammonia butterfly purine and sulphur thiazole purine are comparatively safe and effective. Can also consider employing ring phosphorus amide in case of recuring. Foreign one report show, 50 patient 33 case effective to purine of first ammonia butterfly, other 9 must add with splash Buddhist nun to be loose while being low dose of, but medicines stop to recur, most patients are still effective after offering first ammonia butterfly purine again, indicate first ammonia butterfly purine only relieves but not cures tubercle. Have report reveal, use the intersection of sulphur and the intersection of thiazole and purine separately or share until chronic tubercle the same as purine of first ammonia butterfly in curative effect of disease with cortical hormone. Mustard of nitrogen benzene butanoic acid (but tumour would rather) Because toxicity is more greatly to eliminate gradually. The intersection of ring and the intersection of phosphorus and amide because toxicity large too, used in difficult to cure venereal disease example only at present.
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The therapeutic adaptation card of glucocorticoid of tubercle still has objection, to some slight cases, for instance skin damage, before grape membrane inflammation or cough,etc.,only need cortical hormones some not to be treated, whole body tubercle usually needs oral cortical hormone, heart and nervous system pathological change, high blood calcium and eye pathological change failing to respond to any medical treatment to the part are the therapeutic adaptation card of oral cortical hormone. The the whole body cortical hormone treatment of tubercle still have objection outside lung and other lungs, but most scholars should consider the cortical hormone treatment of whole body while thinking that there are symptom and going on development. Have symptom but have continuation lung soak or person who go on the intersection of lung and function too should consider the intersection of whole body and the intersection of and the intersection of cortical hormone and treatment lose. To needing the patient that long-term cortical hormone treats, should consider resisting the use of malaria medicine and malicious medicine of cell, can consider implementing the lung and transplanting the skill while being few to cure venereal disease example while being difficult.
1.Glucocorticoid
Early research shows, short-term oral cortical hormone can relieve respiratory tract symptom, improve the intersection of lung and soak and the intersection of lung and function that X-ray reveal, repeat, examine, reveal cortisone over a longer period treat, can make granulation to be swollen to relieve too while being alive. But stop, treat, often can cause symptom and lung soak recur, have report in stop, treat how patient more than 1/3 recurs in the 2 year.
Therapeutic suitable dosage and course of treatment about cortical hormone are still scarce to seek unity of standard, but in conformity with the individual. To lung tubercle, the initial dosage is usually to splash the Buddhist nun loose for 20- 40mg every other day (prednisone) Or equivalent other cortical hormone, the heart or nervous system pathological change should increase the dosage appropriately, 1- should assess curative effect after the 3 month, treat through 3 month still getting invalid even lengthen time can effective either, should look for reason failed to treat, such as irreversibility fiber take and dosage enough for and endogenous sex hormone tolerate, hormone should from decrement to every day or 5- 10mg every other day, should treat at least 12 month continuously gradually when being treatment effective, cortical hormone decrement or stop after should pay attention to not recuring,because if you can't recur, need not keeping not treating low dose ofly for a long time repeatedly to some patient.
Tubercle skin damage, iris inflammation, grape and membrane inflammation, nasal polyp or angry way pathological change can be treated with some cortical hormone, lung tubercle can be adopted and sucked cortical hormone too.
2.Malicious medicine of cell
The malicious medicine of cell has already verified that there is precise clinical curative effect among some patients, among them first ammonia butterfly purine and sulphur thiazole purine are comparatively safe and effective. Can also consider employing ring phosphorus amide in case of recuring. Foreign one report show, 50 patient 33 case effective to purine of first ammonia butterfly, other 9 must add with splash Buddhist nun to be loose while being low dose of, but medicines stop to recur, most patients are still effective after offering first ammonia butterfly purine again, indicate first ammonia butterfly purine only relieves but not cures tubercle. Have report reveal, use the intersection of sulphur and the intersection of thiazole and purine separately or share until chronic tubercle the same as purine of first ammonia butterfly in curative effect of disease with cortical hormone. Mustard of nitrogen benzene butanoic acid (but tumour would rather) Because toxicity is more greatly to eliminate gradually. The intersection of ring and the intersection of phosphorus and amide because toxicity large too, used in difficult to cure venereal disease example only at present.
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's general knowledge of diagnosis of tubercle
's general knowledge of diagnosis of tubercle
1,Diagnostic standard and basis
The diagnosis main basis clinical manifestation of tubercle, pathological evidence, and after getting rid of other granulation swollen diseases, can diagnose. Chinese Medical Association breathe disease learn the intersection of tubercle and disease study group, carry on the 3rd revision to clinic and pathological diagnosis, tubercle of disease 1993, the diagnostic standard is as follows.
(1)Clinical diagnostic standard: The chest block reveals one pair of sides lung door and mediastinal symmetrical enlargement of lymph nodes (the accidental single enlargement of lymph nodes of side lung door) ,Accompany or not with netted, tubercle, flaky shade in the lung. Consult the chest CT to carry on by stages if necessary. It verifies or accords with tubercle (note to organize examining alive: The position is a swelling simple table lymph node to draw materials, in it is swelling it is mediastinal for lymph node, bronchus tubercle of membrane, before lymph node and liver puncture or lung be examined,etc. to be lived oblique angle skin cushions fat) . Kveim tests the positive reaction. Serum angiotensin changes enzyme (SACE) The activity rises (accept the hormone treatment or tubercle patient without activity in the normal range) . It is the negative or weak positive reaction that 5TU PPD-S tests 5TU tuberculin test. High blood calcium, high urine, alkaline phosphatase increases, immunoglobulin (Ig) of blood plasma increases, the bronchus alveolus is irritated in lotion T lymphocytes and the inferior inspection result of group are waited for and can be regarded as the reference which diagnoses the activity of tubercle. Can be made when there are conditions. After 67Ga nuclide is injected, employ SPECT to show the picture or take pictures, in order to understand intensity and range that pathological change infringes.
Have Or One person can diagnose as tubercle. (used before numerals to form ordinal numbers) One is important reference index. Pay attention to judging synthetically, observing dynamically.
(2)Pathologic diagnostic standard: The pathologic change of tubercle lacks the specificity, therefore pathological diagnosis must be combined clinically. The following characteristics support the pathological diagnosis of tubercle. Pathological change mainly for at that cell make up granulation is swollen tubercle in skin kind,there are getting less relatively in volume on tubercle, all kinds of shape is more unanimous, the edge knows. There is not a kind of necrosis of cheese in tubercle, there is cellulose a kind of necrosis of special mess nature in the centre of accidental tubercle. At tubercle it is many to be have core afterbirths big and small often and it come loose on a small quantity in lymphocyte. More lymphocytes are soaked around, wrap up to move round the fibrous tissue on later stage, tubercle can be merged each other a long time, but usually still keep the original tubercle outline. Forgive thing Schumann (Schaumann) in the big and small afterbirth Small body, pair refract light crystalline star probability of body relatively the intersection of tuberculosis and tubercle as more, especially more the intersection of Schumann and little body, lean towards under the mere microscope seeing more pair refract light tubercle, brief tubercle on disease. And tubercle has a large amount of netted fibrous hyperplasia around. Dye and has not seen the tuberculosis fungus (many visual field inspections of oil mirror) specially Or pathogenic microbe such as the fungi. Small blood vessel of very accidental thin wall in tubercle.
(3)The diagnosis term of tubercle:
According to the histologic characteristic of pathology, the diagnosis term combining the clinical materials and considering the following 3 situations.
Diagnose as tubercle: Pathologic finding model, the clinical feature is typical too.
Do not get rid of other tubercle: For swollen pathological change of the granulation, the pathologic characteristic is not typical, clinical manifestation model or not typical.
One kind of responses of locality tubercle: Basically accord with tubercle on histology, but there are other already clear diseases at the same time, for instance: Malignant tumour,etc..
Granulation swollen disease not clear of the mechanism that tubercle a kind of cause of disease and has illness coming on. Clinical manifestation is different and behaving differently according to organs given much trouble. The focal point diagnosed lies in getting rid of other diseases. Chest slice, serum ACE level and biopsy are main means to diagnose tubercle. The range, position are helpful that 67Ga nuclide scans to finding pathological change in early days.
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1,Diagnostic standard and basis
The diagnosis main basis clinical manifestation of tubercle, pathological evidence, and after getting rid of other granulation swollen diseases, can diagnose. Chinese Medical Association breathe disease learn the intersection of tubercle and disease study group, carry on the 3rd revision to clinic and pathological diagnosis, tubercle of disease 1993, the diagnostic standard is as follows.
(1)Clinical diagnostic standard: The chest block reveals one pair of sides lung door and mediastinal symmetrical enlargement of lymph nodes (the accidental single enlargement of lymph nodes of side lung door) ,Accompany or not with netted, tubercle, flaky shade in the lung. Consult the chest CT to carry on by stages if necessary. It verifies or accords with tubercle (note to organize examining alive: The position is a swelling simple table lymph node to draw materials, in it is swelling it is mediastinal for lymph node, bronchus tubercle of membrane, before lymph node and liver puncture or lung be examined,etc. to be lived oblique angle skin cushions fat) . Kveim tests the positive reaction. Serum angiotensin changes enzyme (SACE) The activity rises (accept the hormone treatment or tubercle patient without activity in the normal range) . It is the negative or weak positive reaction that 5TU PPD-S tests 5TU tuberculin test. High blood calcium, high urine, alkaline phosphatase increases, immunoglobulin (Ig) of blood plasma increases, the bronchus alveolus is irritated in lotion T lymphocytes and the inferior inspection result of group are waited for and can be regarded as the reference which diagnoses the activity of tubercle. Can be made when there are conditions. After 67Ga nuclide is injected, employ SPECT to show the picture or take pictures, in order to understand intensity and range that pathological change infringes.
Have Or One person can diagnose as tubercle. (used before numerals to form ordinal numbers) One is important reference index. Pay attention to judging synthetically, observing dynamically.
(2)Pathologic diagnostic standard: The pathologic change of tubercle lacks the specificity, therefore pathological diagnosis must be combined clinically. The following characteristics support the pathological diagnosis of tubercle. Pathological change mainly for at that cell make up granulation is swollen tubercle in skin kind,there are getting less relatively in volume on tubercle, all kinds of shape is more unanimous, the edge knows. There is not a kind of necrosis of cheese in tubercle, there is cellulose a kind of necrosis of special mess nature in the centre of accidental tubercle. At tubercle it is many to be have core afterbirths big and small often and it come loose on a small quantity in lymphocyte. More lymphocytes are soaked around, wrap up to move round the fibrous tissue on later stage, tubercle can be merged each other a long time, but usually still keep the original tubercle outline. Forgive thing Schumann (Schaumann) in the big and small afterbirth Small body, pair refract light crystalline star probability of body relatively the intersection of tuberculosis and tubercle as more, especially more the intersection of Schumann and little body, lean towards under the mere microscope seeing more pair refract light tubercle, brief tubercle on disease. And tubercle has a large amount of netted fibrous hyperplasia around. Dye and has not seen the tuberculosis fungus (many visual field inspections of oil mirror) specially Or pathogenic microbe such as the fungi. Small blood vessel of very accidental thin wall in tubercle.
(3)The diagnosis term of tubercle:
According to the histologic characteristic of pathology, the diagnosis term combining the clinical materials and considering the following 3 situations.
Diagnose as tubercle: Pathologic finding model, the clinical feature is typical too.
Do not get rid of other tubercle: For swollen pathological change of the granulation, the pathologic characteristic is not typical, clinical manifestation model or not typical.
One kind of responses of locality tubercle: Basically accord with tubercle on histology, but there are other already clear diseases at the same time, for instance: Malignant tumour,etc..
Granulation swollen disease not clear of the mechanism that tubercle a kind of cause of disease and has illness coming on. Clinical manifestation is different and behaving differently according to organs given much trouble. The focal point diagnosed lies in getting rid of other diseases. Chest slice, serum ACE level and biopsy are main means to diagnose tubercle. The range, position are helpful that 67Ga nuclide scans to finding pathological change in early days.
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The cover of tubercle damages _'s general knowledge outside
The cover of tubercle damages _'s general knowledge outside
Tubercle (Sarcoidosis) Also calling one kind of tumours of meat has names such as one kind of tumour Schaumann benign lymphocytic granulation swollen diseases of Boeck meat and Besnier and a kind of lupus of hemorrhoid,etc.. It is a kind of chronic granulation swollen disease. Solid to have broken to have the intersection of skin and damage of subjective symptoms also can invade mucous membrane, lymph node, skeleton, organ inside the body and claim the intersection of whole body and sarcomatous disease outside while being routed. Tubercle is the first whole body disease, besides skin damage, a lot of organs are given much trouble.
(1)Lymph node pathological change
The enlargement of lymph nodes accounts for 50% all over. Tubercle disease early to limited to the shank or enlargement of lymph nodes of armpit only often, later on enlargement of lymph nodes of whole body, especially vertical diaphragm and enlargement of lymph nodes of lung door.
(2)Eye damage
Tubercle eyes are given much trouble and accounted for 25%- 30%, there are iris inflammation, iris cilliary inflammation. The most common one is granulation swollen tubercle of the iris. The lachrymal gland is involved, for the nodular swelling not aching, lachrymal gland pathological change is often with the enlargement of lymph nodes of shank, the gland, salivary gland and parotid gland are involved under the jaw (Mikulicz syndrome) . There can also be conjunctivitis, keratitis, retinitis and look at the nervous lesion, cause and lose one's sight.
(3)Lung damage
It is given much trouble more commonly that the lung is dirty. X-ray examination is a point-like, strip or flaky shade. Enlargement of lymph nodes of lung door. Early clinical symptom is relatively light, but it is very obvious to check and behave the silk; The anaphase lung fiber is obvious.
(4)Bone joint
Phalange joint swelling, pain, there can be spongy cavities in X-ray examination, one kind of damages of the cyst is mostly had the skin kind cell group form, similar to damage being seen of skin.
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Tubercle (Sarcoidosis) Also calling one kind of tumours of meat has names such as one kind of tumour Schaumann benign lymphocytic granulation swollen diseases of Boeck meat and Besnier and a kind of lupus of hemorrhoid,etc.. It is a kind of chronic granulation swollen disease. Solid to have broken to have the intersection of skin and damage of subjective symptoms also can invade mucous membrane, lymph node, skeleton, organ inside the body and claim the intersection of whole body and sarcomatous disease outside while being routed. Tubercle is the first whole body disease, besides skin damage, a lot of organs are given much trouble.
(1)Lymph node pathological change
The enlargement of lymph nodes accounts for 50% all over. Tubercle disease early to limited to the shank or enlargement of lymph nodes of armpit only often, later on enlargement of lymph nodes of whole body, especially vertical diaphragm and enlargement of lymph nodes of lung door.
(2)Eye damage
Tubercle eyes are given much trouble and accounted for 25%- 30%, there are iris inflammation, iris cilliary inflammation. The most common one is granulation swollen tubercle of the iris. The lachrymal gland is involved, for the nodular swelling not aching, lachrymal gland pathological change is often with the enlargement of lymph nodes of shank, the gland, salivary gland and parotid gland are involved under the jaw (Mikulicz syndrome) . There can also be conjunctivitis, keratitis, retinitis and look at the nervous lesion, cause and lose one's sight.
(3)Lung damage
It is given much trouble more commonly that the lung is dirty. X-ray examination is a point-like, strip or flaky shade. Enlargement of lymph nodes of lung door. Early clinical symptom is relatively light, but it is very obvious to check and behave the silk; The anaphase lung fiber is obvious.
(4)Bone joint
Phalange joint swelling, pain, there can be spongy cavities in X-ray examination, one kind of damages of the cyst is mostly had the skin kind cell group form, similar to damage being seen of skin.
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Mechanism's _ symptom of cause of disease and having illness coming on of tubercle
Mechanism's _ symptom of cause of disease and having illness coming on of tubercle
Cause of disease of of tubercle is not so obvious. Infected the factor correctly ' For instance bacterium, virus, mycoplasma, fungi,etc.) Observe, has not obtained the precise conclusion. Carry on research to the inherent cause too, fail to verify. The author finds in the tubercle patient the tubercle bacillus DNA positive rate reaches 50% with PCR technology in recent years, because some proposition tubercles are that the branched bacillus invade the result organized, a lot of experiments have not verified this argument. The importance that the majority think cell immunological function and humoral immunological function disorder are tubercle has illness coming on in the mechanism now. A certain ' Some) Cause it under the stimulus of the antigen of tubercle, the macrophages(Am) in the alveolus Activated with T4 cells. Released the leucocyte by Am activated to lie between plainly- 1( IL- 1) ,IL- 1 is a kind of very strong lymphocytic factor, can stimulate lymphocytes and release IL- 2, make T4 cells increase at double and under the function of the lymphokine, make B lymphocytes activate, release immunoglobulin (Ig), the function of one's own antibody is hyperfunction. The lymphocytes activated can release monocyte factor, leucocyte of hastening and melting to inhibit factor and macrophage from moving the conduct and inhibiting the factor. The monocyte trends towards the factor of melting to make the monocyte in the blood around assemble to the quality among the alveolus continually, tubercle the density is nearly 25 times of the blood in his alveolus at the disease. Under a lot of unknown antigen and function of the medium, T lymphocytes, the monocyte and macrophage,etc. are soaked in the alveolus, form the early stage of of tubercle - -Alveolus inflammation stage. With the development of pathological change, the cell composition of alveolus inflammation is reducing constantly, and macrophages are derivatized have one kind of cells of skin to increase gradually, in the granulation that he formated and secreted is swollen stimulates the factor (granuloma-inciting factor) ,etc. function under,cheese for tubercle swollen in granulation in disease. On later stage, the fiber that release macrophages links plain(fibronectin, Fn)s Can attract becoming fibrous cells (Fb) of a large number of ,Make it and ground substance adhere to outside the cell, in addition, what macrophage secrete become fibrous the intersection of cell and growth factor (growth factor of fibroblasts, GFF) ,Impel into fibrous cells and count and increase; Meanwhile, inflammation and immune cell around so that disappear while further reducing, and cause the extensive fiber of the lung.
In a word, antigen and the cell immunity of organism and result that the humoral immunological function contends each other that tubercle is unknown. Because of the individual's difference ' Age, gender, race, inherent cause, hormone, HLA) With the immunoreactive regulating action of antibody, look at its promotion factor produced and resist the out-of-balance state between the factors short of moneyly, and determine the swollen development of granulation and disappear, demonstrate tubercle different pathologic state and trend that the nature relieves.
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Cause of disease of of tubercle is not so obvious. Infected the factor correctly ' For instance bacterium, virus, mycoplasma, fungi,etc.) Observe, has not obtained the precise conclusion. Carry on research to the inherent cause too, fail to verify. The author finds in the tubercle patient the tubercle bacillus DNA positive rate reaches 50% with PCR technology in recent years, because some proposition tubercles are that the branched bacillus invade the result organized, a lot of experiments have not verified this argument. The importance that the majority think cell immunological function and humoral immunological function disorder are tubercle has illness coming on in the mechanism now. A certain ' Some) Cause it under the stimulus of the antigen of tubercle, the macrophages(Am) in the alveolus Activated with T4 cells. Released the leucocyte by Am activated to lie between plainly- 1( IL- 1) ,IL- 1 is a kind of very strong lymphocytic factor, can stimulate lymphocytes and release IL- 2, make T4 cells increase at double and under the function of the lymphokine, make B lymphocytes activate, release immunoglobulin (Ig), the function of one's own antibody is hyperfunction. The lymphocytes activated can release monocyte factor, leucocyte of hastening and melting to inhibit factor and macrophage from moving the conduct and inhibiting the factor. The monocyte trends towards the factor of melting to make the monocyte in the blood around assemble to the quality among the alveolus continually, tubercle the density is nearly 25 times of the blood in his alveolus at the disease. Under a lot of unknown antigen and function of the medium, T lymphocytes, the monocyte and macrophage,etc. are soaked in the alveolus, form the early stage of of tubercle - -Alveolus inflammation stage. With the development of pathological change, the cell composition of alveolus inflammation is reducing constantly, and macrophages are derivatized have one kind of cells of skin to increase gradually, in the granulation that he formated and secreted is swollen stimulates the factor (granuloma-inciting factor) ,etc. function under,cheese for tubercle swollen in granulation in disease. On later stage, the fiber that release macrophages links plain(fibronectin, Fn)s Can attract becoming fibrous cells (Fb) of a large number of ,Make it and ground substance adhere to outside the cell, in addition, what macrophage secrete become fibrous the intersection of cell and growth factor (growth factor of fibroblasts, GFF) ,Impel into fibrous cells and count and increase; Meanwhile, inflammation and immune cell around so that disappear while further reducing, and cause the extensive fiber of the lung.
In a word, antigen and the cell immunity of organism and result that the humoral immunological function contends each other that tubercle is unknown. Because of the individual's difference ' Age, gender, race, inherent cause, hormone, HLA) With the immunoreactive regulating action of antibody, look at its promotion factor produced and resist the out-of-balance state between the factors short of moneyly, and determine the swollen development of granulation and disappear, demonstrate tubercle different pathologic state and trend that the nature relieves.
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The healing solution _'s treatment of tubercle
The healing solution _'s treatment of tubercle
1.It has not been bright that hormone treats cause of disease of of tubercle, there is no specific treatment. It is still a first-selected medicine that glucocorticoid of renal gland is abbreviated as hormone, but differ to its view of adapting to card, course of treatment, consumption and curative effect. One view think tubercle disease must have limit nature since, need hormone treat. Once the intersection of disease and limit since, a few will send again only. The hormone treatment can make the granulation swollen and lighten, but can't change the natural course of disease, the granulation was swollen may recur after medicines stopped. Another view thinks hormone can inhibit T lymphocyte hyperplasia and function of T lymphocytic effect cells, prevent the release of the lymphocytic factor, inhibit the alveolus inflammation and swollen forming of granulation, thus reduce the lung function to damage, so advocate early application. But consider there are tubercles from limit nature, and hormone has obvious side effects, so usually only act as the important organ ' Lung, kidney, heart or central nervous system) Function give much trouble or have hypercalcemia at the disease, give hormone treatment just.
I stage patient can not need to treat temporarily, reexamine once in 6 months. There is 2 stage patient whose breathing hard, coughing, chest aches that should treat; Should do 67Ga to scan and check with the lymphocytes in BAIF to the 2 stage patient without symptom first, pathological change have high activity person should offer, treat, getting obvious activity 6 reexamine once month. A patient should act as 67Ga scan and BAL check, the pathological change activity person must be treated. Tubercle should all be treated in principle outside the chest. Treat tubercle and usually select for use and splash the Buddhist nun loose. Treatment and dosage are as follows.
The treatment of every day: Initial dosage every day 30- 40mg, serious the intersection of disease person and 40- 60mg/d, decrement under 6 month, until 10-15mg/d of keeping etc.. The course of treatment is 1- 2 years.
The treatment of a day: It splash Buddhist nun it is loose 50- 50mg/d,after being at 2- 6 week should decrement,keep dosage should to can keep final one by dosages lowest of therapeutic effect, splash the intersection of Buddhist nun and loose 10- 15mg/d, can keep, treat function and side effect lower usually. The course of treatment is 1- 1.5 years.
Suck and treat: Endure Germany (Budesonide) sucking the cloth 0.8mg, 2 times d, being used in 2, a patient can replace oral hormone all or partly. Begin to splash the Buddhist nun and use medicine with oral administration at the same time loose in 2- 3 months, switch over to using separately and sucking writingses to maintain and treat later, the course of treatment the same as uses medicine all over. Active the intersection of lung and the intersection of tubercle and disease have focus person outside the lung, can use separately hormone treat, symptom can add the part to treat with the whole body treatment while being getting serious. Side reaction of hormone and treatment: Reduce the emergence that the dosage can reduce the chance infection greatly. The weight increases and liquid retention can be controlled by diet. Diabetes may be aggravated because of using hormone, it is used that should be careful. In employing the hormone treatment, in view of morbidity of tuberculosis of our country being relatively high, can add and obey isonicotinyl hydrazine every day 0.3g at the same time if necessary.
2.The indole is beautiful and hard and the others are not that the body of steroid resist inflammation medicine effective to arthritis of Loffgren's syndrome. For hormone it can't meet or with after curative effect is getting better can also select for use. If can protect too loose with hydroxyl, 100mg/d, the course of treatment is 3- 6 months, curative effect is like hormone.
3.Chloroquine, to inhibiting the skin pathological changes of lung fiber and tubercle effectively, but application, 250mg, 4 times d, changes into for 2 times every week of 250mg 3 months later, course of treatment is 6 months.
4.Sulphur thiazole purine sulphur thiazole purine 100mg, 4 times d, the course of treatment is 3 months, are used for using hormone and invalid patient of chloroquine. The purine of butterfly of chlorine first: Fiber take and the intersection of skin and pathological change have certain result to lung, long-term administration can also cause the intersection of lung and fiber take. The benzene butanoic acid nitrogen mustard has valid reports too.
5.It is for lung been amino for benzoic acid it take fiber, hemorrhoid lupus effective,can with cortical hormone, chloroquine be used to be replaced.
6.Other immunity strengthen anticlockwise imidazole of pharmaceutical, shifting factor, thymosin,etc.. Will keep out of the sun apparent calcium supersession of influencing tubercle waits to fix. If hypercalcemia disease exists, can consider limiting the intaking amount of calcium in the diet. Tubercle treats the principle: Carry on the possible part treatment; Once use hormone, should use for at least one year (the decrement gradually) ; The induction dosage of relieving symptom is greater than maintaining the dosage. The healing solution should follow the condition decision.
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1.It has not been bright that hormone treats cause of disease of of tubercle, there is no specific treatment. It is still a first-selected medicine that glucocorticoid of renal gland is abbreviated as hormone, but differ to its view of adapting to card, course of treatment, consumption and curative effect. One view think tubercle disease must have limit nature since, need hormone treat. Once the intersection of disease and limit since, a few will send again only. The hormone treatment can make the granulation swollen and lighten, but can't change the natural course of disease, the granulation was swollen may recur after medicines stopped. Another view thinks hormone can inhibit T lymphocyte hyperplasia and function of T lymphocytic effect cells, prevent the release of the lymphocytic factor, inhibit the alveolus inflammation and swollen forming of granulation, thus reduce the lung function to damage, so advocate early application. But consider there are tubercles from limit nature, and hormone has obvious side effects, so usually only act as the important organ ' Lung, kidney, heart or central nervous system) Function give much trouble or have hypercalcemia at the disease, give hormone treatment just.
I stage patient can not need to treat temporarily, reexamine once in 6 months. There is 2 stage patient whose breathing hard, coughing, chest aches that should treat; Should do 67Ga to scan and check with the lymphocytes in BAIF to the 2 stage patient without symptom first, pathological change have high activity person should offer, treat, getting obvious activity 6 reexamine once month. A patient should act as 67Ga scan and BAL check, the pathological change activity person must be treated. Tubercle should all be treated in principle outside the chest. Treat tubercle and usually select for use and splash the Buddhist nun loose. Treatment and dosage are as follows.
The treatment of every day: Initial dosage every day 30- 40mg, serious the intersection of disease person and 40- 60mg/d, decrement under 6 month, until 10-15mg/d of keeping etc.. The course of treatment is 1- 2 years.
The treatment of a day: It splash Buddhist nun it is loose 50- 50mg/d,after being at 2- 6 week should decrement,keep dosage should to can keep final one by dosages lowest of therapeutic effect, splash the intersection of Buddhist nun and loose 10- 15mg/d, can keep, treat function and side effect lower usually. The course of treatment is 1- 1.5 years.
Suck and treat: Endure Germany (Budesonide) sucking the cloth 0.8mg, 2 times d, being used in 2, a patient can replace oral hormone all or partly. Begin to splash the Buddhist nun and use medicine with oral administration at the same time loose in 2- 3 months, switch over to using separately and sucking writingses to maintain and treat later, the course of treatment the same as uses medicine all over. Active the intersection of lung and the intersection of tubercle and disease have focus person outside the lung, can use separately hormone treat, symptom can add the part to treat with the whole body treatment while being getting serious. Side reaction of hormone and treatment: Reduce the emergence that the dosage can reduce the chance infection greatly. The weight increases and liquid retention can be controlled by diet. Diabetes may be aggravated because of using hormone, it is used that should be careful. In employing the hormone treatment, in view of morbidity of tuberculosis of our country being relatively high, can add and obey isonicotinyl hydrazine every day 0.3g at the same time if necessary.
2.The indole is beautiful and hard and the others are not that the body of steroid resist inflammation medicine effective to arthritis of Loffgren's syndrome. For hormone it can't meet or with after curative effect is getting better can also select for use. If can protect too loose with hydroxyl, 100mg/d, the course of treatment is 3- 6 months, curative effect is like hormone.
3.Chloroquine, to inhibiting the skin pathological changes of lung fiber and tubercle effectively, but application, 250mg, 4 times d, changes into for 2 times every week of 250mg 3 months later, course of treatment is 6 months.
4.Sulphur thiazole purine sulphur thiazole purine 100mg, 4 times d, the course of treatment is 3 months, are used for using hormone and invalid patient of chloroquine. The purine of butterfly of chlorine first: Fiber take and the intersection of skin and pathological change have certain result to lung, long-term administration can also cause the intersection of lung and fiber take. The benzene butanoic acid nitrogen mustard has valid reports too.
5.It is for lung been amino for benzoic acid it take fiber, hemorrhoid lupus effective,can with cortical hormone, chloroquine be used to be replaced.
6.Other immunity strengthen anticlockwise imidazole of pharmaceutical, shifting factor, thymosin,etc.. Will keep out of the sun apparent calcium supersession of influencing tubercle waits to fix. If hypercalcemia disease exists, can consider limiting the intaking amount of calcium in the diet. Tubercle treats the principle: Carry on the possible part treatment; Once use hormone, should use for at least one year (the decrement gradually) ; The induction dosage of relieving symptom is greater than maintaining the dosage. The healing solution should follow the condition decision.
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Pathologic _'s general knowledge of cause of disease of tubercle
Pathologic _'s general knowledge of cause of disease of tubercle
The mechanism with having illness coming on of the cause of disease: The cause of disease of tubercle is not so obvious. Infected the factor correctly ' For instance bacterium, virus, mycoplasma, fungi,etc.) Observe, has not obtained the precise conclusion. Carry on research to the inherent cause too, fail to verify. The author finds in the tubercle patient the tubercle bacillus DNA positive rate reaches 50% with PCR technology in recent years, so it is that the branched bacillus invades the result organized to put forward tubercle, but a lot of experiments have not verified this argument. The importance that the majority think cell immunological function and humoral immunological function disorder are tubercle has illness coming on in the mechanism now. A certain ' Some) Cause it under the stimulus of the antigen of tubercle, the macrophages(Am) in the alveolus Activated with T4 cells. Released the leucocyte by Am activated to lie between plainly- 1( IL- 1) ,IL- 1 is a kind of very strong lymphocytic factor, can stimulate lymphocytes and release IL- 2, make T4 cells increase at double and under the function of the lymphokine, make B lymphocytes activate, release immunoglobulin (Ig), the function of one's own antibody is hyperfunction. The lymphocytes activated can release monocyte factor, leucocyte of hastening and melting to inhibit factor and macrophage from moving the conduct and inhibiting the factor. The monocyte trends towards the factor of melting to make the monocyte in the blood around assemble to the quality among the alveolus continually, tubercle the density is nearly 25 times of the blood in his alveolus at the disease. Under a lot of unknown antigen and function of the medium, T lymphocytes, the monocyte and macrophage,etc. are soaked in the alveolus, form the early stage of of tubercle - -Alveolus inflammation stage. With the development of pathological change, the cell composition of alveolus inflammation is reducing constantly, and macrophages are derivatized have one kind of cells of skin to increase gradually, in the granulation that he formated and secreted is swollen stimulates the factor (granuloma-inciting factor) ,etc. function under,is it typical to form gradually it is cheese tubercle swollen in granulation in disease. On later stage, the fiber that release macrophages links plain(fibronectin, Fn)s Can attract becoming fibrous cells (Fb) of a large number of ,Make it and ground substance adhere to outside the cell, in addition, what macrophage secrete become fibrous the intersection of cell and growth factor (growth factor of fibroblasts, GFF) ,Impel into fibrous cells and count and increase; Meanwhile, inflammation and immune cell around so that disappear while further reducing, and cause the extensive fiber of the lung.
In a word, antigen and the cell immunity of organism and result that the humoral immunological function contends each other that tubercle is unknown. Because of the individual's difference ' Age, gender, race, inherent cause, hormone, HLA) With the immunoreactive regulating action of antibody, look at its promotion factor produced and resist the out-of-balance state between the factors short of moneyly, and determine the swollen development of granulation and disappear, demonstrate tubercle different pathologic state and trend that the nature relieves.
Pathology: It can be seen for the gathering of one kind of cells of skin in organizing the section that the granulation of tubercle is swollen, among them there are the nuclear macrophages more, have lymphocytes around, but there is not one kind of pathological changes (Fig. of cheese 2- 11- 1) . Can see, forgive body in the bubble thick liquid of macrophages, such as ovate Schumann (Schaumann) Small body, a pair of small body (asteroid body) of crystallization and star refracting light . Lung tubercle have illness coming on, become, have more extensive monocyte, macrophage, alveolus inflammation that lymphocyte soaked the beginning in disease, involve the alveolus wall and a quality. It may be dissipated by oneself that the alveolus inflammation and granulation are swollen. But in chronic stage, granulation swollen around fibrous the intersection of master cell and collagen take and not hyaline, become the non- specific fiber. It has no characteristic that swollen tissue morphology of the granulation displays, it is obvious in branched bacillus and fungal infection, it is the tissue of foreign matter or traumatism that reacts, also can be seen at beryllium disease, syphilis of third, lymphoma and other source alveolus inflammation of allergy,etc., should walk and distinguish. But see the same tissue pathological change in many organs, combine the clinical materials, can diagnose a disease.
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The mechanism with having illness coming on of the cause of disease: The cause of disease of tubercle is not so obvious. Infected the factor correctly ' For instance bacterium, virus, mycoplasma, fungi,etc.) Observe, has not obtained the precise conclusion. Carry on research to the inherent cause too, fail to verify. The author finds in the tubercle patient the tubercle bacillus DNA positive rate reaches 50% with PCR technology in recent years, so it is that the branched bacillus invades the result organized to put forward tubercle, but a lot of experiments have not verified this argument. The importance that the majority think cell immunological function and humoral immunological function disorder are tubercle has illness coming on in the mechanism now. A certain ' Some) Cause it under the stimulus of the antigen of tubercle, the macrophages(Am) in the alveolus Activated with T4 cells. Released the leucocyte by Am activated to lie between plainly- 1( IL- 1) ,IL- 1 is a kind of very strong lymphocytic factor, can stimulate lymphocytes and release IL- 2, make T4 cells increase at double and under the function of the lymphokine, make B lymphocytes activate, release immunoglobulin (Ig), the function of one's own antibody is hyperfunction. The lymphocytes activated can release monocyte factor, leucocyte of hastening and melting to inhibit factor and macrophage from moving the conduct and inhibiting the factor. The monocyte trends towards the factor of melting to make the monocyte in the blood around assemble to the quality among the alveolus continually, tubercle the density is nearly 25 times of the blood in his alveolus at the disease. Under a lot of unknown antigen and function of the medium, T lymphocytes, the monocyte and macrophage,etc. are soaked in the alveolus, form the early stage of of tubercle - -Alveolus inflammation stage. With the development of pathological change, the cell composition of alveolus inflammation is reducing constantly, and macrophages are derivatized have one kind of cells of skin to increase gradually, in the granulation that he formated and secreted is swollen stimulates the factor (granuloma-inciting factor) ,etc. function under,is it typical to form gradually it is cheese tubercle swollen in granulation in disease. On later stage, the fiber that release macrophages links plain(fibronectin, Fn)s Can attract becoming fibrous cells (Fb) of a large number of ,Make it and ground substance adhere to outside the cell, in addition, what macrophage secrete become fibrous the intersection of cell and growth factor (growth factor of fibroblasts, GFF) ,Impel into fibrous cells and count and increase; Meanwhile, inflammation and immune cell around so that disappear while further reducing, and cause the extensive fiber of the lung.
In a word, antigen and the cell immunity of organism and result that the humoral immunological function contends each other that tubercle is unknown. Because of the individual's difference ' Age, gender, race, inherent cause, hormone, HLA) With the immunoreactive regulating action of antibody, look at its promotion factor produced and resist the out-of-balance state between the factors short of moneyly, and determine the swollen development of granulation and disappear, demonstrate tubercle different pathologic state and trend that the nature relieves.
Pathology: It can be seen for the gathering of one kind of cells of skin in organizing the section that the granulation of tubercle is swollen, among them there are the nuclear macrophages more, have lymphocytes around, but there is not one kind of pathological changes (Fig. of cheese 2- 11- 1) . Can see, forgive body in the bubble thick liquid of macrophages, such as ovate Schumann (Schaumann) Small body, a pair of small body (asteroid body) of crystallization and star refracting light . Lung tubercle have illness coming on, become, have more extensive monocyte, macrophage, alveolus inflammation that lymphocyte soaked the beginning in disease, involve the alveolus wall and a quality. It may be dissipated by oneself that the alveolus inflammation and granulation are swollen. But in chronic stage, granulation swollen around fibrous the intersection of master cell and collagen take and not hyaline, become the non- specific fiber. It has no characteristic that swollen tissue morphology of the granulation displays, it is obvious in branched bacillus and fungal infection, it is the tissue of foreign matter or traumatism that reacts, also can be seen at beryllium disease, syphilis of third, lymphoma and other source alveolus inflammation of allergy,etc., should walk and distinguish. But see the same tissue pathological change in many organs, combine the clinical materials, can diagnose a disease.
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The diagnosis of tubercle is according to _'s treatment
The diagnosis of tubercle is according to _'s treatment
1.It is swelling that the chest image learns to check and show one pair of sides lung door and mediastinal lymph node symmetry, accompany or not with the netted, tubercle or flaky shade in the lung.
2.Histology examine, verify, it has to be the intersection of the universe and the intersection of junket nature and necrosis swollen granulation while being living, resist acid, dye negative.
3.Serum angiotensin rises more than enzyme S A C E activity of melting.
4.Lie between in vain plainly serum or B A L F - 2 receptor (I L - 2 R) The level increases.
5.Old tuberculin (O T) Or it is negative or weak and positive to test P P D.
Lymphocyte count> 10, 4 C D C D 8 ratio gt in the 6 B A L F; =3 .
7.High blood calcium, high urine.
8.Kveim test positive.
9.Except tuberculosis or others granulation is swollen for disease.
In the above-mentioned 9, 1, 2, 8 is the major indicator, the others are secondary indexes.
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1.It is swelling that the chest image learns to check and show one pair of sides lung door and mediastinal lymph node symmetry, accompany or not with the netted, tubercle or flaky shade in the lung.
2.Histology examine, verify, it has to be the intersection of the universe and the intersection of junket nature and necrosis swollen granulation while being living, resist acid, dye negative.
3.Serum angiotensin rises more than enzyme S A C E activity of melting.
4.Lie between in vain plainly serum or B A L F - 2 receptor (I L - 2 R) The level increases.
5.Old tuberculin (O T) Or it is negative or weak and positive to test P P D.
Lymphocyte count> 10, 4 C D C D 8 ratio gt in the 6 B A L F; =3 .
7.High blood calcium, high urine.
8.Kveim test positive.
9.Except tuberculosis or others granulation is swollen for disease.
In the above-mentioned 9, 1, 2, 8 is the major indicator, the others are secondary indexes.
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Symptom of tubercle and _'s symptom of the physical sign
Symptom of tubercle and _'s symptom of the physical sign
Tubercle and symptom depend on being given much trouble the position, there can not be, slight, or serious. At the beginning, can generate heat, the weight lightens and arthralgia. The liver is given much trouble hotly continuously. The peripheral enlargement of lymph nodes is common, often have no symptom. Important lymph node can also have granulation to be swollen even. Organ but function continue person who take place fiber take and damage. Cough and it has difficulty in breathing to be may be very much slight and No.
Chronic the intersection of tubercle and patient often have skin pathological change (spot piece, papule, the skin makes the brief summary) ,Nasal mucosa and combine at the membrane can also take place granulation to be swollenning. Nodular erythema, often with generating heat and arthralgia, it is European's common symptom, less in American philtrums.
70% of the patients make and puncture alive and can find to examine that there is swollen granulation of liver by the leather liver, they can not have symptom and the liver function is checked normally. The patient that 10% are less than has hepatomegaly. The serious going on liver function obstacle accompanies jaundice to be rare.
15% of the patients have swollen plain layer of inflammation of wink of granulation, it is usually dual sides. If not treated, the eyesight that it is serious to be can be caused by that the retina is given much trouble is lowered, there can also be serious vitreous inflammation or then sending glaucoma. There can be swelling lachrymal gland once in a while, the conjunctiva and eyelid are soaked, doing keratitis.
5%~10% of the patient cardiac muscle is given much trouble, can cause angina pectoris, in heart failure, or cause the fatal character to conduct unusually.
Acute much arthritis can be very outstanding. Swelling around the chronic joint and it touches a tender spot to be may be caused by bone qualitative change in the phalange. Inflammation is common around the acute ankle joint, there is not dermatosis that is decreased, are not often thought to have tubercle.
The central nervous system is given much trouble and can be shown as nearly pathological changes of any type, but the most common one is cranial nerve paralysis (especially the facial nerve is paralysed) ,Involve 5% of the patients.
Diabetes insipidus can take place. The intersection of hypercalcemia and disease and high the intersection of calcium and the intersection of urine and disease (alveolus macrophage and tubercle disease granulation swollen to secrete 1, due to 25 - two hydroxy vitamin D increase) Can cause kidney stone and calcium calm disease of the kidney and cause the renal function to be depleted, but prednisone can reduce the incidence of the supersession disorder of calcium. The gland function is hyperfunction to seem to unusually see more by first form, not when hypercalcemia disease does not have fast reaction to the steroids medicine of cortex, should consider this kind of possibility.
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Tubercle and symptom depend on being given much trouble the position, there can not be, slight, or serious. At the beginning, can generate heat, the weight lightens and arthralgia. The liver is given much trouble hotly continuously. The peripheral enlargement of lymph nodes is common, often have no symptom. Important lymph node can also have granulation to be swollen even. Organ but function continue person who take place fiber take and damage. Cough and it has difficulty in breathing to be may be very much slight and No.
Chronic the intersection of tubercle and patient often have skin pathological change (spot piece, papule, the skin makes the brief summary) ,Nasal mucosa and combine at the membrane can also take place granulation to be swollenning. Nodular erythema, often with generating heat and arthralgia, it is European's common symptom, less in American philtrums.
70% of the patients make and puncture alive and can find to examine that there is swollen granulation of liver by the leather liver, they can not have symptom and the liver function is checked normally. The patient that 10% are less than has hepatomegaly. The serious going on liver function obstacle accompanies jaundice to be rare.
15% of the patients have swollen plain layer of inflammation of wink of granulation, it is usually dual sides. If not treated, the eyesight that it is serious to be can be caused by that the retina is given much trouble is lowered, there can also be serious vitreous inflammation or then sending glaucoma. There can be swelling lachrymal gland once in a while, the conjunctiva and eyelid are soaked, doing keratitis.
5%~10% of the patient cardiac muscle is given much trouble, can cause angina pectoris, in heart failure, or cause the fatal character to conduct unusually.
Acute much arthritis can be very outstanding. Swelling around the chronic joint and it touches a tender spot to be may be caused by bone qualitative change in the phalange. Inflammation is common around the acute ankle joint, there is not dermatosis that is decreased, are not often thought to have tubercle.
The central nervous system is given much trouble and can be shown as nearly pathological changes of any type, but the most common one is cranial nerve paralysis (especially the facial nerve is paralysed) ,Involve 5% of the patients.
Diabetes insipidus can take place. The intersection of hypercalcemia and disease and high the intersection of calcium and the intersection of urine and disease (alveolus macrophage and tubercle disease granulation swollen to secrete 1, due to 25 - two hydroxy vitamin D increase) Can cause kidney stone and calcium calm disease of the kidney and cause the renal function to be depleted, but prednisone can reduce the incidence of the supersession disorder of calcium. The gland function is hyperfunction to seem to unusually see more by first form, not when hypercalcemia disease does not have fast reaction to the steroids medicine of cortex, should consider this kind of possibility.
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Monday, January 28, 2013
The intersection of tubercle and the intersection of disease and cause of disease and have illness coming on the intersection of mechanism and the intersection of _ and general knowledge
The intersection of tubercle and the intersection of disease and cause of disease and have illness coming on the intersection of mechanism and the intersection of _ and general knowledge
The mechanism with having illness coming on of the cause of disease: The cause of disease is not so obvious. Infected the factor correctly ' For instance bacterium, virus, mycoplasma, fungi,etc.) Observe, has not obtained the precise conclusion. Carry on research to the inherent cause too, fail to verify. The author finds in the tubercle patient the tubercle bacillus DNA positive rate reaches 50% with PCR technology in recent years, so it is that the branched bacillus invades the result organized to put forward tubercle, but a lot of experiments have not verified this argument. The importance that the majority think cell immunological function and humoral immunological function disorder are tubercle has illness coming on in the mechanism now. A certain ' Some) Cause it under the stimulus of the antigen of tubercle, the macrophages(Am) in the alveolus Activated with T4 cells. Released the leucocyte by Am activated to lie between plainly- 1( IL- 1) ,IL- 1 is a kind of very strong lymphocytic factor, can stimulate lymphocytes and release IL- 2, make T4 cells increase at double and under the function of the lymphokine, make B lymphocytes activate, release immunoglobulin (Ig), the function of one's own antibody is hyperfunction. The lymphocytes activated can release monocyte factor, leucocyte of hastening and melting to inhibit factor and macrophage from moving the conduct and inhibiting the factor. The monocyte trends towards the factor of melting to make the monocyte in the blood around assemble to the quality among the alveolus continually, tubercle the density is nearly 25 times of the blood in his alveolus at the disease. Under a lot of unknown antigen and function of the medium, T lymphocytes, the monocyte and macrophage,etc. are soaked in the alveolus, form the early stage of of tubercle - -Alveolus inflammation stage. With the development of pathological change, the cell composition of alveolus inflammation is reducing constantly, and macrophages are derivatized have one kind of cells of skin to increase gradually, in the granulation that he formated and secreted is swollen stimulates the factor (granuloma-inciting factor) ,etc. function under,is it typical to form gradually cheese tubercle swollen in granulation in disease. On later stage, the fiber that release macrophages links plain(fibronectin, Fn)s Can attract becoming fibrous cells (Fb) of a large number of ,Make it and ground substance adhere to outside the cell, in addition, what macrophage secrete become fibrous the intersection of cell and growth factor (growth factor of fibroblasts, GFF) ,Impel into fibrous cells and count and increase; Meanwhile, inflammation and immune cell around so that disappear while further reducing, and cause the extensive fiber of the lung.
In a word, antigen and the cell immunity of organism and result that the humoral immunological function contends each other that tubercle is unknown. Because of the individual's difference ' Age, gender, race, inherent cause, hormone, HLA) With the immunoreactive regulating action of antibody, look at its promotion factor produced and resist the out-of-balance state between the factors short of moneyly, and determine the swollen development of granulation and disappear, demonstrate tubercle different pathologic state and trend that the nature relieves.
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The mechanism with having illness coming on of the cause of disease: The cause of disease is not so obvious. Infected the factor correctly ' For instance bacterium, virus, mycoplasma, fungi,etc.) Observe, has not obtained the precise conclusion. Carry on research to the inherent cause too, fail to verify. The author finds in the tubercle patient the tubercle bacillus DNA positive rate reaches 50% with PCR technology in recent years, so it is that the branched bacillus invades the result organized to put forward tubercle, but a lot of experiments have not verified this argument. The importance that the majority think cell immunological function and humoral immunological function disorder are tubercle has illness coming on in the mechanism now. A certain ' Some) Cause it under the stimulus of the antigen of tubercle, the macrophages(Am) in the alveolus Activated with T4 cells. Released the leucocyte by Am activated to lie between plainly- 1( IL- 1) ,IL- 1 is a kind of very strong lymphocytic factor, can stimulate lymphocytes and release IL- 2, make T4 cells increase at double and under the function of the lymphokine, make B lymphocytes activate, release immunoglobulin (Ig), the function of one's own antibody is hyperfunction. The lymphocytes activated can release monocyte factor, leucocyte of hastening and melting to inhibit factor and macrophage from moving the conduct and inhibiting the factor. The monocyte trends towards the factor of melting to make the monocyte in the blood around assemble to the quality among the alveolus continually, tubercle the density is nearly 25 times of the blood in his alveolus at the disease. Under a lot of unknown antigen and function of the medium, T lymphocytes, the monocyte and macrophage,etc. are soaked in the alveolus, form the early stage of of tubercle - -Alveolus inflammation stage. With the development of pathological change, the cell composition of alveolus inflammation is reducing constantly, and macrophages are derivatized have one kind of cells of skin to increase gradually, in the granulation that he formated and secreted is swollen stimulates the factor (granuloma-inciting factor) ,etc. function under,is it typical to form gradually cheese tubercle swollen in granulation in disease. On later stage, the fiber that release macrophages links plain(fibronectin, Fn)s Can attract becoming fibrous cells (Fb) of a large number of ,Make it and ground substance adhere to outside the cell, in addition, what macrophage secrete become fibrous the intersection of cell and growth factor (growth factor of fibroblasts, GFF) ,Impel into fibrous cells and count and increase; Meanwhile, inflammation and immune cell around so that disappear while further reducing, and cause the extensive fiber of the lung.
In a word, antigen and the cell immunity of organism and result that the humoral immunological function contends each other that tubercle is unknown. Because of the individual's difference ' Age, gender, race, inherent cause, hormone, HLA) With the immunoreactive regulating action of antibody, look at its promotion factor produced and resist the out-of-balance state between the factors short of moneyly, and determine the swollen development of granulation and disappear, demonstrate tubercle different pathologic state and trend that the nature relieves.
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Check and diagnose _'s symptom in the laboratory of tubercle
Check and diagnose _'s symptom in the laboratory of tubercle
90% of the patient's chests of of tubercle are unusual in X-ray examination. Regular chest X-ray examination can often find that there are mediastinal lymph node pathological changes. It is in fact general for X-ray examination to find ' 90% of the patients) There is lymph node pathological change by door and the right side bronchus of one pair of sides lung, though can be seen single side pathological change once in a while. The lung soaks and presents tiny rubing the hyaline change of sand of disperse on the X-ray stretch, but it appears with lymph node pathological change at the same time or thereafter; Or there is not lymph node pathological change that can be seen; Or is shown as the netted or granulous pathological change of millet; Or take the form of and merge form or big tubercle, is similar to shifting the focus. Cough and it has difficulty in breathing to be may be very much slight and No. The result is a lung fiber in later period of going on disease, the bag turns into and lung source heart disease.
Often there are leucocytes that are reduced. The serum uric acid is often raised, but there is little gout. The result that the liver is given much trouble makes serum alkaline phosphatase and - valley ammonia acyl transfer to peptide enzyme and rise. The inhibition of late hairdo hypersensitivity is the characteristic, but negative second intensity tuberculin reaction must exclude from erupting pulmonary tuberculosis simultaneously. Black philtrum often has high gamma globulin blood disease.
The lung function is checked and shown and breathed limitedly, the complying with is reduced, disperse ability is weakened. CO2 retention is uncommon, though with often having a angry way to block in the lung fiber or great patient that chases with the disease or later period in the bronchus. It is important to act as the lung function and check for estimating the progress of course of disease and guiding treating regularly.
The patient without symptom if has typical chest X-ray slice to behave, can diagnose as tubercle; If chest slice is normal, but above-mentioned symptom and physical sign must consider tubercle. Because differential diagnosis including lymphoma and fungal infection (for example organize the thick liquid fungus disease of afterbirth, sporular fungus disease of ball) ,It is essential to organize examining checking with microbiological histology alive, if there is symptom and have therapeutic indication of steroids of cortex. If there is simple pathological change that may be touched of tables (such as in the cover inside, lymph node or conjunctiva) ,Sample that examined alive, positive rate of tubercle> is 85%.
When the peripheral position can't do alive and examine, it is to offer the first best step of histologic evidence of of tubercle to sample alive and examine through the fibrous bronchus mirror. Can see the granulation in 50%~80% of the patients swollenly, no matter chest X-ray block reveals whether the lung is soaked or there is lung door lymph node pathological change only. Can also adopt the lung to organize the sample through the thorax mirror.
Can make alive position that examine, include the intersection of appearance and normal conjunctiva or mediastinal while being other, the latter can be sampled by the mediastinal incision or mediastinal mirror. Liver live 70% case it is obvious granulation to be swollen examine. Must get rid of the single organ ' Such as liver) Some tubercle of China reacts, the granulation of lung is swollen that infect, hypersensitivity and foreign matter react. When there is doubt, should examine alive in several places, look for infecting or foreign matter to react carefully.
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90% of the patient's chests of of tubercle are unusual in X-ray examination. Regular chest X-ray examination can often find that there are mediastinal lymph node pathological changes. It is in fact general for X-ray examination to find ' 90% of the patients) There is lymph node pathological change by door and the right side bronchus of one pair of sides lung, though can be seen single side pathological change once in a while. The lung soaks and presents tiny rubing the hyaline change of sand of disperse on the X-ray stretch, but it appears with lymph node pathological change at the same time or thereafter; Or there is not lymph node pathological change that can be seen; Or is shown as the netted or granulous pathological change of millet; Or take the form of and merge form or big tubercle, is similar to shifting the focus. Cough and it has difficulty in breathing to be may be very much slight and No. The result is a lung fiber in later period of going on disease, the bag turns into and lung source heart disease.
Often there are leucocytes that are reduced. The serum uric acid is often raised, but there is little gout. The result that the liver is given much trouble makes serum alkaline phosphatase and - valley ammonia acyl transfer to peptide enzyme and rise. The inhibition of late hairdo hypersensitivity is the characteristic, but negative second intensity tuberculin reaction must exclude from erupting pulmonary tuberculosis simultaneously. Black philtrum often has high gamma globulin blood disease.
The lung function is checked and shown and breathed limitedly, the complying with is reduced, disperse ability is weakened. CO2 retention is uncommon, though with often having a angry way to block in the lung fiber or great patient that chases with the disease or later period in the bronchus. It is important to act as the lung function and check for estimating the progress of course of disease and guiding treating regularly.
The patient without symptom if has typical chest X-ray slice to behave, can diagnose as tubercle; If chest slice is normal, but above-mentioned symptom and physical sign must consider tubercle. Because differential diagnosis including lymphoma and fungal infection (for example organize the thick liquid fungus disease of afterbirth, sporular fungus disease of ball) ,It is essential to organize examining checking with microbiological histology alive, if there is symptom and have therapeutic indication of steroids of cortex. If there is simple pathological change that may be touched of tables (such as in the cover inside, lymph node or conjunctiva) ,Sample that examined alive, positive rate of tubercle> is 85%.
When the peripheral position can't do alive and examine, it is to offer the first best step of histologic evidence of of tubercle to sample alive and examine through the fibrous bronchus mirror. Can see the granulation in 50%~80% of the patients swollenly, no matter chest X-ray block reveals whether the lung is soaked or there is lung door lymph node pathological change only. Can also adopt the lung to organize the sample through the thorax mirror.
Can make alive position that examine, include the intersection of appearance and normal conjunctiva or mediastinal while being other, the latter can be sampled by the mediastinal incision or mediastinal mirror. Liver live 70% case it is obvious granulation to be swollen examine. Must get rid of the single organ ' Such as liver) Some tubercle of China reacts, the granulation of lung is swollen that infect, hypersensitivity and foreign matter react. When there is doubt, should examine alive in several places, look for infecting or foreign matter to react carefully.
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Clinical manifestation _ symptom of tubercle
Clinical manifestation _ symptom of tubercle
Tubercle is a kind of whole body granulation swollen disease, involve skin and a lot of internal organs. The position given much trouble has lung, vertical diaphragm and lymph node, phalange, cardiac muscle, central nervous system, liver, spleen, kidney, eyes and parotid gland around besides skin. Tubercle disease can infringe one organ or organization only, can also many kinds of organ or organization are infringed meanwhile. The condition passes slowly, relieves and recurs alternatively. The clinical symptom of this disease is varied.
The skin that first, skin display tubercle behaves
It is many kinds of shapes, often in order that the papule, tubercle, spot piece, red cover are ill, silver bits disease kind, one kind of tumours of scar meat, pigment fail and the bald head is damaged. The cover is decreased and distributed over places such as face and four limbs,etc. asymmetrically. It is flexible that it is touched that rash is hard, expand under the cover gradually, involve the thickness of the whole dermis. The change of the epidermis is not obvious, can become thin, change color slightly, the capillary expands and a few scales bits. It is often rubescent to purple brown, non- routed and broken, there is not subjective symptoms.
1,One kind of tumours of papule meat
Damage it for the syringe needle to the pea size small tubercle, is also called one kind of tumours of grains of meat of millet. Mainly distribute over the face, shank and shoulder. The intersection of glass and block shows faint yellow snack to similar to lupus tubercle, disappear and step back and does not leave the trace while pressing, leave over pigment spot, withers and cicatrix sometimes.
2,One kind of tumours of piece type meat of spot
Hutchinson has reported this unique spot bulk is damaged, as flat and slight high great points of foliate nodular spot pieces that get up of surface at first, common on the cheek, nose and arm.
3,Disease, a kind of meat and one kind of tumours of silver bits
Often the clear spot piece of border happen on truck and four limbs, there are scale bits of disease kind of silver bits on it.
4,Hemorrhoid is one kind of lupus types
On the position of the easy emergence hemorrhoid, for instance: Ear, cheek department, nose, meaning the blue and green red or mauve spot piece with simpler symmetrical infiltration that appears of toe.
5,The cover plays one kind of tumours of meat
Also called one kind of tumours of Darier-Roussy meat. The bean is to son's big solid skin lower tubercle of millet, with the skin adhesion, common on the truck, the face is rare, there is not subjective symptoms.
6,One kind of tumours of meat of cicatrix
Damage and happen on the scar position. For instance: On the scar after burn, folliculitis, herpes zoster. Make the original scar area expand, highly increase, is exactly like the scar hang-up.
7,One kind of tumours of red cover ill type meat
Infiltration erythema and scale's bits patch of the filling the air distribution are unclear in the border.
8,One kind of tumours of nodular erythema type meat
Some patient, disease of tubercle, arthralgic companion generate heat and erythrocyte sedimentation rate increase soon in order to person who occur frequently, enlargement of lymph nodes of X-ray examination lung door. The face, back and four limbs stretch the side and happen scatteredly at pain skin lower tubercle. The skin of surface is ruddy, most common to young women.
9,One kind of tumours of mucomembranous meat
Buccal hard jaw, cheek department, hang and stop up hanging down and big papule of amygdaline syringe needle, troop and merge and form the flat spot piece, small tubercle happens in the conjunctiva of eyelid and lachrymal gland.
10,Other skin damages
Tubercle disease can amalgamate have skin lower calcium calm, itch rash, many shape erythema and folliculitis display. Skin wither and horn take excessive increasing or it fails to be can also caused by this disease by pigment.
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Tubercle is a kind of whole body granulation swollen disease, involve skin and a lot of internal organs. The position given much trouble has lung, vertical diaphragm and lymph node, phalange, cardiac muscle, central nervous system, liver, spleen, kidney, eyes and parotid gland around besides skin. Tubercle disease can infringe one organ or organization only, can also many kinds of organ or organization are infringed meanwhile. The condition passes slowly, relieves and recurs alternatively. The clinical symptom of this disease is varied.
The skin that first, skin display tubercle behaves
It is many kinds of shapes, often in order that the papule, tubercle, spot piece, red cover are ill, silver bits disease kind, one kind of tumours of scar meat, pigment fail and the bald head is damaged. The cover is decreased and distributed over places such as face and four limbs,etc. asymmetrically. It is flexible that it is touched that rash is hard, expand under the cover gradually, involve the thickness of the whole dermis. The change of the epidermis is not obvious, can become thin, change color slightly, the capillary expands and a few scales bits. It is often rubescent to purple brown, non- routed and broken, there is not subjective symptoms.
1,One kind of tumours of papule meat
Damage it for the syringe needle to the pea size small tubercle, is also called one kind of tumours of grains of meat of millet. Mainly distribute over the face, shank and shoulder. The intersection of glass and block shows faint yellow snack to similar to lupus tubercle, disappear and step back and does not leave the trace while pressing, leave over pigment spot, withers and cicatrix sometimes.
2,One kind of tumours of piece type meat of spot
Hutchinson has reported this unique spot bulk is damaged, as flat and slight high great points of foliate nodular spot pieces that get up of surface at first, common on the cheek, nose and arm.
3,Disease, a kind of meat and one kind of tumours of silver bits
Often the clear spot piece of border happen on truck and four limbs, there are scale bits of disease kind of silver bits on it.
4,Hemorrhoid is one kind of lupus types
On the position of the easy emergence hemorrhoid, for instance: Ear, cheek department, nose, meaning the blue and green red or mauve spot piece with simpler symmetrical infiltration that appears of toe.
5,The cover plays one kind of tumours of meat
Also called one kind of tumours of Darier-Roussy meat. The bean is to son's big solid skin lower tubercle of millet, with the skin adhesion, common on the truck, the face is rare, there is not subjective symptoms.
6,One kind of tumours of meat of cicatrix
Damage and happen on the scar position. For instance: On the scar after burn, folliculitis, herpes zoster. Make the original scar area expand, highly increase, is exactly like the scar hang-up.
7,One kind of tumours of red cover ill type meat
Infiltration erythema and scale's bits patch of the filling the air distribution are unclear in the border.
8,One kind of tumours of nodular erythema type meat
Some patient, disease of tubercle, arthralgic companion generate heat and erythrocyte sedimentation rate increase soon in order to person who occur frequently, enlargement of lymph nodes of X-ray examination lung door. The face, back and four limbs stretch the side and happen scatteredly at pain skin lower tubercle. The skin of surface is ruddy, most common to young women.
9,One kind of tumours of mucomembranous meat
Buccal hard jaw, cheek department, hang and stop up hanging down and big papule of amygdaline syringe needle, troop and merge and form the flat spot piece, small tubercle happens in the conjunctiva of eyelid and lachrymal gland.
10,Other skin damages
Tubercle disease can amalgamate have skin lower calcium calm, itch rash, many shape erythema and folliculitis display. Skin wither and horn take excessive increasing or it fails to be can also caused by this disease by pigment.
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Clinical manifestation _ symptom of tubercle
Clinical manifestation _ symptom of tubercle
Clinical manifestation, tubercle of disease it looks at the pressing or otherwise and amounts to involve organ of disease to be but different. Tubercle is too early to often have obvious symptom and physical sign in the chest. Have, cough sometimes, cough a small amount of the intersection of phlegm and liquid, spit blood on a small quantity while being accidental; There can be weak, generating heat, night sweating, appetite failing, weight to lighten etc.. Can present out of breath, even cyanosis uncomfortable in chest when pathological change is extensive. But because amalgamate infection, pulmonary emphysema, bronchiectasis, original heart disease of the lung,etc. and aggravate the condition. If tubercle involves other organs at the same time, corresponding symptom and physical sign can take place. Such as the most common one of skin being nodular erythema, see more the surface shank, shoulder or four limbs. Also there is a kind of lupus (lupus pernio) of hemorrhoid , macule, papule when. Find lower tubercle of the skin sometimes. It can be caused and depilated to infringe the scalp. Probably about 30% of patients can present the skin damage. The eye sufferer nearly has 15% of the cases, there can be iris cilliary inflammation, acute pigment one layer of inflammation, cornea - conjunctivitis,etc.. Can appear eyes ache, eyesight fuzzy and cilliary congest etc. display. Some patients have liver sum ' Or) Splenomegaly, it is obvious bilirubin increases and rises with alkaline phosphatase slightly, or liver function is damaged. The mediastinal and simple table lymph node is often infringed but swelling. Such as involving joint, skeleton, muscle,etc., there can be occuring frequently small bag ossicle defect of short bone which can be seen four limbs, brothers in multiple arthritis, X-ray examination (bone . It can cause some swelling, pain,etc. that the granulation of muscle is swollen. Nearly 50% of the cases involve the nervous system, his symptom is changeful. Can have the intersection of cranial nerve and paralyse, myopathic taking the intersection of location and the intersection of and the intersection of pathological change, meningitis,etc. and clinical manifestation in the brain nerve. Tubercle disease involve cardiac muscle, can have arrhythmia is even in heart failure to display, nearly 5% of the cases involve the heart. Can also present the pericardium and accumulate the liquid. Tubercle can interfere with the supersession of calcium, cause the blood calcium, urine calcium increases, cause kidney calcium salt depositing and kidney stone. Can cause diabetes insipidus involve pituitary, play, depend on mound can take place milk to be too much to secrete, rise usually with the milk of serum give much trouble. To parotid gland, tonsil, throat, thyroid gland, renal gland, pancreas, stomach, reproductive system when given much trouble, can cause relevant symptoms and physical sign, but relatively rare.
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Clinical manifestation, tubercle of disease it looks at the pressing or otherwise and amounts to involve organ of disease to be but different. Tubercle is too early to often have obvious symptom and physical sign in the chest. Have, cough sometimes, cough a small amount of the intersection of phlegm and liquid, spit blood on a small quantity while being accidental; There can be weak, generating heat, night sweating, appetite failing, weight to lighten etc.. Can present out of breath, even cyanosis uncomfortable in chest when pathological change is extensive. But because amalgamate infection, pulmonary emphysema, bronchiectasis, original heart disease of the lung,etc. and aggravate the condition. If tubercle involves other organs at the same time, corresponding symptom and physical sign can take place. Such as the most common one of skin being nodular erythema, see more the surface shank, shoulder or four limbs. Also there is a kind of lupus (lupus pernio) of hemorrhoid , macule, papule when. Find lower tubercle of the skin sometimes. It can be caused and depilated to infringe the scalp. Probably about 30% of patients can present the skin damage. The eye sufferer nearly has 15% of the cases, there can be iris cilliary inflammation, acute pigment one layer of inflammation, cornea - conjunctivitis,etc.. Can appear eyes ache, eyesight fuzzy and cilliary congest etc. display. Some patients have liver sum ' Or) Splenomegaly, it is obvious bilirubin increases and rises with alkaline phosphatase slightly, or liver function is damaged. The mediastinal and simple table lymph node is often infringed but swelling. Such as involving joint, skeleton, muscle,etc., there can be occuring frequently small bag ossicle defect of short bone which can be seen four limbs, brothers in multiple arthritis, X-ray examination (bone . It can cause some swelling, pain,etc. that the granulation of muscle is swollen. Nearly 50% of the cases involve the nervous system, his symptom is changeful. Can have the intersection of cranial nerve and paralyse, myopathic taking the intersection of location and the intersection of and the intersection of pathological change, meningitis,etc. and clinical manifestation in the brain nerve. Tubercle disease involve cardiac muscle, can have arrhythmia is even in heart failure to display, nearly 5% of the cases involve the heart. Can also present the pericardium and accumulate the liquid. Tubercle can interfere with the supersession of calcium, cause the blood calcium, urine calcium increases, cause kidney calcium salt depositing and kidney stone. Can cause diabetes insipidus involve pituitary, play, depend on mound can take place milk to be too much to secrete, rise usually with the milk of serum give much trouble. To parotid gland, tonsil, throat, thyroid gland, renal gland, pancreas, stomach, reproductive system when given much trouble, can cause relevant symptoms and physical sign, but relatively rare.
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Mechanism's _ general knowledge of pathogenic factor and having illness coming on of tubercle
Mechanism's _ general knowledge of pathogenic factor and having illness coming on of tubercle
First, pathogenic factor
The cause of disease of tubercle has not been bright so far, it may be one kind and infects factor, immune factor, one's own immune system disease associating with inherent cause at the same time. The pathological hypothesis of the immunity thinks, tubercle is under the function of some unknown antigen, mainly started the cell immunity of tubercle to reply by macrophages; Macrophages release many kinds of factors, such as IL-1, cause T to assist cell gathering and hyperplasia; T assists cells to secrete the cell factor, hastens and melts and gathers other inflammatory cells. In addition, are produced immunoglobulin (Ig) to increase by B lymphocytes after stimulating, begin hyperplasia too as fibrous cells. The above-mentioned immunology changes interaction to lead to the fact it is being swollen that the inflammatory cell is being given much trouble the hyperplasia of organ and formed the granulation.
Second, have illness coming on in the mechanism
It is the important amynologic characteristic of tubercle that the cell immunological function is low, are shown as peripheral blood lymphocytes are reduced, to many kinds of late person who send the intersection of skin and test react, subside or disappear, irritate lotion (BALF) to patient of tubercle disease the intersection of bronchus and alveolus Finding,increase macrophage at BALF and lymphocyte absolute number obviously, but the proportion that macrophages account for drops but the lymphocyte proportion rises, indicate the position of disease T cell function is obviously strengthened, drop and form the contrast with peripheral blood T lymphocytes, the two present and separate the phenomenon. Until the intersection of T and the intersection of cell and inferior group analyze, find activity issues of patient of tubercle disease T assist and induce cells (CD4) further in the BALF Obviously increase, and T inhibiting malicious cells (CD8) of cell It is normal to be lower than. Make CD4/CD8 ratio obviously rise.
Tubercle disease granulation is swollen from at there make up is skin kinds of cell, macrophage and some effect cell. Its mechanism is under the function of the outside antigen, T cell and macrophages in the alveolus are activated, release a series of lymphocytic factor, the ones that include T cells to emerge are lain between in vain plainly - 2 (IL-2)s , the factor (MCF) of hastening and melting of the monocyte , the monocyte moves the conduct and inhibits the factor (MIF) The ones that produce with macrophages are lain between in vain plainly - l (IL-1) . IL-1 can impel T lymphocytes to move the conduct to the intersection of pathological change and activity department, and impel its hyperplasia and division, form alveolus inflammation finishing a disease and relying mainly on the fact that inflammation cells or immune effect cells such as T cells, the monocyte and alveolus macrophage,etc. are soaked in early days, IL-1 can also make IL-2 receptor in surface of T cell expose, and impel T cells to release IL-2, IL-2 stimulates B cells, produce immunoglobulin (Ig) in the form of cloning more, can be seen high 's globulin blood disease at being clinical, as pathological change continues progress, the cell composition of alveolus inflammation is reducing constantly, have one kind of cells of skin and increase gradually, and it is not that the cheese granulation is swollen to form a typical one under the swollen function of stimulating the factor of granulation that it secretes gradually. On tubercle later stage, the fibrous conjugated proteln that release macrophages absorbs a large number of fibrous master cells, meanwhile, inflammation and immune effect cell around so that disappear while further reducing, cause the extensive fiber finally.
Organize pathology, the early pathology of tubercle displays mainly T lymphocyte, monocyte and macrophage soak alveolus inflammation caused in the alveolus; Until pathological change develop, the intersection of cell and composition, alveolus of inflammation reduce constantly, and upper the intersection of peel and kinds of cell that macrophage derive and become increase and preponderate gradually, under formating and secreting swollen function which stimulate the factor of the granulation, it is not that a kind of tubercle granulation of cheese is swollen to form a typical one gradually; Pathological change later stage, the connection that alveolus macrophages release is plain can be attracted and become fibrous cells in a large amount, make it and ground substance stick outside the cell, in addition what macrophage secrete become fibrous the intersection of cell and growth factor impel fibrous the intersection of cell and hyperplasia, cause the extensive fiber of lung. Acute the intersection of tubercle and the intersection of disease and arthritis and the intersection of patient and the intersection of joint and slippery membrane and tendon sheath of tenosynovitis examine pathology, show cheese swollen kind of granulation changes while being living, and there are T lymphocytes that are soaked; Chronic the intersection of tubercle and the intersection of joint and slippery membrane, disease of arthritis become extensive hyperplasia, tubercle joint, disease of arthritis accumulate liquid, ooze out liquid for inflammation nature; Patient's slippery membrane of inflammation is organized normally around the tubercle joint.
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First, pathogenic factor
The cause of disease of tubercle has not been bright so far, it may be one kind and infects factor, immune factor, one's own immune system disease associating with inherent cause at the same time. The pathological hypothesis of the immunity thinks, tubercle is under the function of some unknown antigen, mainly started the cell immunity of tubercle to reply by macrophages; Macrophages release many kinds of factors, such as IL-1, cause T to assist cell gathering and hyperplasia; T assists cells to secrete the cell factor, hastens and melts and gathers other inflammatory cells. In addition, are produced immunoglobulin (Ig) to increase by B lymphocytes after stimulating, begin hyperplasia too as fibrous cells. The above-mentioned immunology changes interaction to lead to the fact it is being swollen that the inflammatory cell is being given much trouble the hyperplasia of organ and formed the granulation.
Second, have illness coming on in the mechanism
It is the important amynologic characteristic of tubercle that the cell immunological function is low, are shown as peripheral blood lymphocytes are reduced, to many kinds of late person who send the intersection of skin and test react, subside or disappear, irritate lotion (BALF) to patient of tubercle disease the intersection of bronchus and alveolus Finding,increase macrophage at BALF and lymphocyte absolute number obviously, but the proportion that macrophages account for drops but the lymphocyte proportion rises, indicate the position of disease T cell function is obviously strengthened, drop and form the contrast with peripheral blood T lymphocytes, the two present and separate the phenomenon. Until the intersection of T and the intersection of cell and inferior group analyze, find activity issues of patient of tubercle disease T assist and induce cells (CD4) further in the BALF Obviously increase, and T inhibiting malicious cells (CD8) of cell It is normal to be lower than. Make CD4/CD8 ratio obviously rise.
Tubercle disease granulation is swollen from at there make up is skin kinds of cell, macrophage and some effect cell. Its mechanism is under the function of the outside antigen, T cell and macrophages in the alveolus are activated, release a series of lymphocytic factor, the ones that include T cells to emerge are lain between in vain plainly - 2 (IL-2)s , the factor (MCF) of hastening and melting of the monocyte , the monocyte moves the conduct and inhibits the factor (MIF) The ones that produce with macrophages are lain between in vain plainly - l (IL-1) . IL-1 can impel T lymphocytes to move the conduct to the intersection of pathological change and activity department, and impel its hyperplasia and division, form alveolus inflammation finishing a disease and relying mainly on the fact that inflammation cells or immune effect cells such as T cells, the monocyte and alveolus macrophage,etc. are soaked in early days, IL-1 can also make IL-2 receptor in surface of T cell expose, and impel T cells to release IL-2, IL-2 stimulates B cells, produce immunoglobulin (Ig) in the form of cloning more, can be seen high 's globulin blood disease at being clinical, as pathological change continues progress, the cell composition of alveolus inflammation is reducing constantly, have one kind of cells of skin and increase gradually, and it is not that the cheese granulation is swollen to form a typical one under the swollen function of stimulating the factor of granulation that it secretes gradually. On tubercle later stage, the fibrous conjugated proteln that release macrophages absorbs a large number of fibrous master cells, meanwhile, inflammation and immune effect cell around so that disappear while further reducing, cause the extensive fiber finally.
Organize pathology, the early pathology of tubercle displays mainly T lymphocyte, monocyte and macrophage soak alveolus inflammation caused in the alveolus; Until pathological change develop, the intersection of cell and composition, alveolus of inflammation reduce constantly, and upper the intersection of peel and kinds of cell that macrophage derive and become increase and preponderate gradually, under formating and secreting swollen function which stimulate the factor of the granulation, it is not that a kind of tubercle granulation of cheese is swollen to form a typical one gradually; Pathological change later stage, the connection that alveolus macrophages release is plain can be attracted and become fibrous cells in a large amount, make it and ground substance stick outside the cell, in addition what macrophage secrete become fibrous the intersection of cell and growth factor impel fibrous the intersection of cell and hyperplasia, cause the extensive fiber of lung. Acute the intersection of tubercle and the intersection of disease and arthritis and the intersection of patient and the intersection of joint and slippery membrane and tendon sheath of tenosynovitis examine pathology, show cheese swollen kind of granulation changes while being living, and there are T lymphocytes that are soaked; Chronic the intersection of tubercle and the intersection of joint and slippery membrane, disease of arthritis become extensive hyperplasia, tubercle joint, disease of arthritis accumulate liquid, ooze out liquid for inflammation nature; Patient's slippery membrane of inflammation is organized normally around the tubercle joint.
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