f****6
发帖数: 365 | 1 博后，有绿卡， immunology专业，一直做 autoimmune disease, 有进药厂的希望吗？
谢谢！ |
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i********g
发帖数: 444 | 4 【 以下文字转载自 Pharmaceutical 讨论区 】
发信人: iamleaving (乌龟就是小武,小武就是我的乌龟), 信区: Pharmaceutical
标 题: 想请教几个制药行业的问题
发信站: BBS 未名空间站 (Sat Aug 16 22:35:47 2014, 美东)
我不是life science相关专业的, 但是下周有一个制药公司的面试, 不怎么了解这个行
业, 不知道能不能请大家先帮我简单科普下呢? 倒不是因为懒, 只是对这行业几乎一点
不了解, 实在是不知道从何找起. 而且昨天下午通知的下周面试, 准备时间实在是有限
, 所以想在这里找些关键词和focus, 有了个方向后再仔细去研究下.
我查了网上的一些建议, 说可能面试会设计到类似的几个问题:
1. healthcare这个行业目前和将来的发展方向
2. 制药方面目前哪个领域的药物最热门 (我昨晚和今天一天查了下面试公司的情况,
他们做好几种药物, 抗抑郁, 抗肥胖药物, 治秃头的药, 抗自免疫药还是抗过敏药不太
懂(autoimmune and allergic diseases), 还有一个... 阅读全帖 |
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s**********8
发帖数: 25265 | 5 来自主题: MedicalDevice版 - FDA The Food and Drug Administration (FDA or USFDA) is an agency of the United
States Department of Health and Human Services, one of the United States
federal executive departments. The FDA is responsible for protecting and
promoting public health through the regulation and supervision of food
safety, tobacco products, dietary supplements, prescription and over-the-
counter pharmaceutical drugs (medications), vaccines, biopharmaceuticals,
blood transfusions, medical devices, electromagnetic radiati... 阅读全帖 |
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s********o
发帖数: 3319 | 6 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
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s********o
发帖数: 3319 | 7 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
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d**o
发帖数: 618 | 8 I'm a little confused? Paraneoplastic neurological syndrome is autoimmune
and should not cause brain tumor by itself ah? If you find brain tumor it
should be metastasis, not paraneoplastic ah? |
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d**o
发帖数: 618 | 9 I'm a little confused? Paraneoplastic neurological syndrome is autoimmune
and should not cause brain tumor by itself ah? If you find brain tumor it
should be metastasis, not paraneoplastic ah? |
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f**********n
发帖数: 246 | 10 After ruling out TB, HIV, likely need a abd and chest CT with contrast(
renal cell CA?), Then if all negative go for colonoscopy, then autoimmune
screening. Find a IM physicain as a primary doctor. |
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f**********n
发帖数: 246 | 11 After ruling out TB, HIV, likely need a abd and chest CT with contrast(
renal cell CA?), Then if all negative go for colonoscopy, then autoimmune
screening. Find a IM physicain as a primary doctor. |
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V*****G
发帖数: 337 | 12 Amyloidosis
Hypothyroidism
Parasite infection, e.g. schistosomiasis
Celiac sprue, tropic sprue
Polyglandular autoimmune syndrome
Other autimmune diseases: e.g. Systemic sclerosis
Binecar SE?
How long has she been having hypokalemia?
Hypokalemia:
if started same time as hypertension = primary aldosteronism
if started after HCTZ = SE
if started after diarrhea = due to GI loss
Raynaud syndrome:
if on beta blocker for HTZ, could be SE
systemic sclerosis
Will modify based on day to day update...... |
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m*********6
发帖数: 609 | 13 with FH of autoimmune disease, can it be some kind of autoantibody-related disease? |
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I****a
发帖数: 407 | 14 What issue is primary? What issues are secondary?
It is hard to pinpoint at this moment for me w/o knowing any lab values.
This is likely a systemic process with multiple organ system involvement: GI
, vascular and possible renal and heme. I would guess diagnosis is
eventually made by a pivotal biopsy.
How would you work her up?
I would focus on elucidating the cause of anasarca and hypokalemia,
specifically UA, urine protein/creatinin ratio, urine lytes to calculate
transtubular potassium gradi... 阅读全帖 |
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V*****G
发帖数: 337 | 15 I do have a few questions to ask:
1st about the diagnosis: is diagnosis clear when the biopsy result is clear
or when gluten free diet worked? To me, it's the later. It will be more
helpful to ask patient if there is traveling history to Caribean, India,
Southeast Asia etc.If no such a history, then giving diagnosis when biopsy
result is clear might be reasonable to me. Maybe LZ said this somewhere in
the description that I missed. Anyway I am not clear no this at this point.
The other thing is... 阅读全帖 |
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y***d
发帖数: 33 | 16 I don't think there was a travel history. That was screened during her first
hospitalisation and we didn't go back and ask those questions again whenwe
got the path results back. Would have hake the case better if we did.
About when the diagnosis is confirmed, it was when she got better on gluten
free diet. before that we were highly suspicious but there was still a
little doubt because of those negative serologies. Our GI fellow told her
that he was 90% sure. Then she got better with gluten fre... 阅读全帖 |
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y******a
发帖数: 590 | 17 I will definitely send him to XieHe and repeat all the autoimmune markers, immunoglobulin levels, and recheck all possible parasite infection, and do a quantiferen test. Consider VAST, if all other non-invasive tests can not give a diagnosis. If necessary, he may need repeat bone biopsy.
Sometime the ancillary support (I mean a good reliable lab) is very important. |
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y******a
发帖数: 590 | 18 I still put parasitic infection on the top of the list
then the second on the list is autoimmune disease/vasculitis
Both of them, you need a good lab and pathology department to support the diagnosis.
That's part of the reason I recommmend PUMC-XieHe
TB and malignancy are also possible. These two diagnosis need more invasive
tests to comfirm or exclude. Here in US, rarely we will treat pt with anti
-TB meds without a pathology diagnosis, but I know in China and India, if it
's highly suspecte... 阅读全帖 |
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y******a
发帖数: 590 | 19 For primary immunodeficiency patients, many of them do have autoimmune
features, but in literature, usually these features will resolve by itself
when patients become immunodeficient. |
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y******a
发帖数: 590 | 20 For primary immunodeficiency patients, many of them do have autoimmune
features, but in literature, usually these features will resolve by itself
when patients become immunodeficient. |
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g**1
发帖数: 733 | 21 your triglycerides is high, possible reasons are as follows:
* Obesity.
* Poorly controlled diabetes.
* An underactive thyroid (hypothyroidism).
* Kidney disease.
* Regularly eating more calories than you burn.
* Drinking a lot of alcohol.
Certain medicines may also raise triglycerides. These medicines include:
* Tamoxifen.
* Steroids.
* Beta-blockers.
* Diuretics.
* Estrogen.
* Birth control pills.
what medicines are you taking now? more informat... 阅读全帖 |
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g**1
发帖数: 733 | 22 your triglycerides is high, possible reasons are as follows:
* Obesity.
* Poorly controlled diabetes.
* An underactive thyroid (hypothyroidism).
* Kidney disease.
* Regularly eating more calories than you burn.
* Drinking a lot of alcohol.
Certain medicines may also raise triglycerides. These medicines include:
* Tamoxifen.
* Steroids.
* Beta-blockers.
* Diuretics.
* Estrogen.
* Birth control pills.
what medicines are you taking now? more informat... 阅读全帖 |
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A*******s
发帖数: 9638 | 23
请问您了解Transverse Myelitis的常用的治疗方式么？据医生说，用steriods是惯例
我在网上查到，还有一种是plasmapharesis. Treatment typically consists of one
plasma exchange daily for 5–7 days. 知道那种更有效么?谢谢
TM的机理可能还是autoimmune，可能与最近的病毒感染有关。 大剂量steroids是最常
用的治疗方法， 简单， 没有大的副作用。 可惜steroid的有效性还是有争议， 所以
提倡早诊断，早治疗。 plasmaphresis一般不用， 因为1. 疗效不确定，2 invasive，
小孩很受罪。 所以如果病孩没有危急情况，一般不采用。
大多数TM预后良好， 希望你孩子早日康复。
Bless. |
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I****a
发帖数: 407 | 24 I am not GI but to me it is hard to justify pancreatitis with normal enzyme
in acute setting plus a normal MRCP. With somebody who has autoimmune
tendency, GI vasculitis may be considered in the differential. I agree with
A++, acute intermittent porphyria is possible and a urine porphyrins
including porphobilinogen can be easily done. I guess if all are negative,
she then might have somatization disorder. |
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n****a
发帖数: 2525 | 25 Thanks everyone for replying.
It's been 12 days into her hospital stay, she is still in pain. Her IgG4 to
look for autoimmune pancreatitis was negative, lab ordered for possible
Celiac (which leads to poor absorption of Levothyroxine and pancreatitis
link) also negative. GI still thinks pancreatitis, might have been
exacerbated by cold meds she was taking that has some ETOH content. EGD was
done by GI only showing gastritis. CT ab showed nothing but cysts, no
pancreatic cyst or pseudocyst or oth... 阅读全帖 |
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A*******s
发帖数: 9638 | 26 A very interesting case.
1) I have a question for ChiusMD: Ι型新月体肾小球肾炎与lupus nephritis是什
么关系？ 这个病人有可能是SLE吗？ 当然这个病人是male。
2）Antiphospholipid syndrome很好的解释了病人的中风， 我的一个疑问是， 这个病
人有autoimmune disease， CNS vasculitis有没有考虑？因为前者治疗是
anticoagulation， 后者是激素。
3）PCP感染显然是治疗的消极后果， 我相信这个病人接受了免疫抑制剂包括激素的治
疗。 所以即使病人有CNS vasculitis， 治疗还是激素，真是无奈啊。
这个病人在尿血， 腹腔积液的情况下收入消化病房有点让我消化不了。 |
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A*******s
发帖数: 9638 | 27 我的感觉是， 这个病在开始时就是一个autoimmune disease，可能因为virus感染引起
， kidney是最先影响受影响的器官。 后来影响到CNS和其他器官， 并出现了治疗后引
起的并发症。 早诊断， 早上治疗可能会有不同的结果。
Antiphospholipid AB 在某些情况下可以是假阳性。 |
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m****a
发帖数: 287 | 28 版大，晕啊，BELL'S 不应该是核下瘫，全脸瘫，而且比较对称的？看来我只知一二了。
unilateral HSV-1 infection. The HSV-1 infection associated autoimmune
process explains why the infection was unilateral, but the bell's palsy was
bilateral. So steriods could inhibit the immunoresponse but antiviral
treatment would do nothing about it. Works for prevention? maybe. |
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a**e
发帖数: 5094 | 29 你这个不一定是诱发
你查一下autoimmune disease和mood disorder的关系
人。 |
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A*******s
发帖数: 9638 | 30 Autoimmune Hemolytic Anemia。
Did he take any abtibotics for the diarrhea? |
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d**o
发帖数: 618 | 31 我理解是对病毒的抵抗造成免疫系统失调，autoimmune attack on neurons
所以说病毒感染造成不准确，应该是病毒诱发。不过跟遗传应该没啥关系。 |
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A*******s
发帖数: 9638 | 32 腰穿是在用药前还是用药后？
我觉得第一次发病是因为细菌性脑膜炎（Gram negative）， 不过我不太明白为什么就
用上keppra了？ 事实上seizure还是发生了， keppra并没有起作用。 第二次发病影响
呼吸是因为autoimmune导致延髓/脑干受影响， 可能与感染已经没有直接关系了，这可
以从CSF的检查和培养中看出来。在呼吸困难期间我会用激素治疗， 而不是一味的抗生
素。
如果病人开始康复， 这是个好消息， 今后就是抗癫痫治疗了， 他应该可以逐步恢复
， 不过大脑功能还得过一段时间才能评估。
另外我澄清一下， A++是因为我的一个朋友的故事而起的名， 不是我BSO啊， lol |
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u***e
发帖数: 611 | 33 RA? lupus? smells like autoimmune disease...... |
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y******a
发帖数: 590 | 34 A few questions based on the history you provided:
How long did his GI symptoms last? Any stool tests done?
Besides the fever, abdominal pain, swollen tonsils, any other symptoms like
joint swelling, joint pain, rashes, chest pain, oral ulcers, etc..?
Did he have similar episodes in the past? Why you say he has frequent
tonsilitis and oral ulcers? was it bacterial tonsilitis, or cultures were
always negative? How frequent his oral ulcer is? any recurrent fever in
the past (you say he sometim... 阅读全帖 |
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y******a
发帖数: 590 | 35 I am not convinced that he has immune deficiency. Based on all your posts,
he has not had any positive cultures anywhere. Hypogammaglobulinemia can be
caused by reduced hepatic synthesis, like in patients with cirrhosis. I am
not impressed by hypocomplementia either, for the same reason.
Go back to his history, he has had recurrent fevers for years. Has he ever
had any episode that he did use antibiotics and fever resolved by itself in
a few days? Do his fever episodes follow any patterns? ... 阅读全帖 |
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A*******s
发帖数: 9638 | 36 I believe what LZ meant is frequent tonsillitis with fever. These patients
need tonsilectomy in my opinion. I doubt he has a primary autoimmune disease.
ever
in
4- |
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b******a
发帖数: 704 | 37 In the clinical setting of infection, because patient with primary AIN has
normal bone marrow reserve, the increase in cell production and release from
bone marrow as the reactions to infection and the elevated stress hormone,
such as a corticosteroids, could predominantly exceeds the effect of
autoantibody binding.
In the late phase of infection, the cell number of neutrophils gradually
decreases due to cell apoptosis and reduced cell output and release. In AIN
patients, autoantibodies could q... 阅读全帖 |
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A*******s
发帖数: 9638 | 38 Like what bythesea has posted，the prognosis for autoimmune neutropenia of
infancy is excellent. The condition usually lasts only 2-3 years before
spontaneous resolution, and virtually all patients recover by age 5 years. |
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n*****j
发帖数: 261 | 39 【 以下文字转载自 NextGeneration 讨论区 】
发信人: wwwjobs (minimouse), 信区: NextGeneration
标 题: 求助: 6个月大婴儿肝衰竭 (转载)
发信站: BBS 未名空间站 (Fri Apr 12 07:11:51 2013, 美东)
发信人: wwwjobs (minimouse), 信区: Medicine
标 题: 求助: 6个月大婴儿肝衰竭
发信站: BBS 未名空间站 (Fri Apr 12 05:39:14 2013, 美东)
我慢慢发细节，版主请帮助置顶几天。
宝宝生下来很健康。因为母乳不够，差不多1周大的时候全部营养来自于奶粉。开始几
天similac液体奶，很快就全部是enf的固体奶粉，milk-based.这时候一切正常。除了
，非常容易吐奶，需要很多关心外，吃和拉还行。
还行就是按照医生的说法，其实我们一直觉得孩子把把有些太软。1个多月后，孩子重
量还行，闹得更厉害，吐奶更频繁，于是我们改用sensitive的配方奶粉。孩子清况好
了不少，体重及各方面数据都正常。
3个月前后，孩子的把把开始很稀了，次数更... 阅读全帖 |
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t******9
发帖数: 270 | 40 不知道你是否需要把下面的翻译成中文，试着翻译了一下。
infection 感染
metabolic disease 代谢性疾病
obstruction 梗阻（这里可能指胆道梗阻）
oncologic 肿瘤
autoimmune 自身免疫性疾病
neurologic status.. 神经系统状态
4/9 22:10
rdw 19.0h 红细胞分布宽度
monocytes, abs 2970h 单核细胞绝对数
bands,abs 1080h 不成熟白细胞绝对数
abs neutrophil ct cal 20250h 中性粒细胞绝对数
polys,% 71h 中性粒细胞百分比
monocytes,% 11h 单核细胞百分比
raw reticulocyte count 5.73h 网织红细胞计数百分比
hct corrected retic count 3.9h 根据血容量而修正的网织红细胞计数百分比
sodium level 134L 血钠水平
phosphorus serum 3.4L 血磷水平
white blood cell count 27h 白细胞... 阅读全帖 |
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A*******s
发帖数: 9638 | 41 I believe PANDAS is a syndrome not a disease, a movement disorder initiated
with Strep, followed with autoimmune response.
Like Rheumatic fever mainly involves heart and joints, PANDAS involves brain
. Similar mechanism， different location. |
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w*****s
发帖数: 230 | 42 【 以下文字转载自 Biology 讨论区 】
发信人: wwwjobs (minimouse), 信区: Biology
标 题: 请看看附件图片文字，建议我们能做什么呢？
发信站: BBS 未名空间站 (Thu Jan 16 12:24:03 2014, 美东)
附件是主治大夫的reasoning(email回复，红字)， 他的水平我们还是很佩服的，因为
他已开始猜了个病就和我们宝宝症状非常一致，可惜后来发现不是；而且他不是代谢病
专家。
问题是坚持宝宝不吃长链脂肪酸的奶粉后，他奇迹般地改善了；完全出乎医生们的预料
。我感觉医生列的是常见的代谢病，而我们感觉宝宝吃长链脂肪酸似乎是慢性中毒，大
概需要一个月左右才能体现出来。因为过程很慢，我们怀疑很多方法查不出来。
我们最大的问题是如果是这种病怎么查？不能确认的话他一辈子吃饭都受影响，基本也
就很难出门时间长一点了。尤其是他的肝已经在要换的边缘。医生们现在改口说他的病
程都是偶然，可我们不能同意。为什么每次都是长链吃一段时间就得病，尤其是这次停
了鸡蛋后马上改善。。
谢谢大家。 （下面是文字，可惜设置不成红色）
Q: Our big... 阅读全帖 |
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u***e
发帖数: 611 | 43 pupils nonreactive...he is pretty much brain dead, right?
fever rash for one month, responded to steroid. I feel it's more likely
autoimmune disease, I didn't go through everything though. unfortunate guy. |
|
h*******r
发帖数: 182 | 44 家人过去一年不到受肝功能异常困扰，特来向各位专家求教， 究竟要不要做肝穿刺活
检。 多谢了！
年龄:
72
性别:
女
症状:
No significant signs and symptoms, no abdominal pain, no jaundice, no
diarrhea, normal appetite with regular diet.
病史:
Two episodes of fever (~39 C) lasting less than a week 10 months ago, no
cough, no diarrhea or vomiting. Test showed elevated LFT with AST/ALT ~400-
500 U. Viral profile showed negative for HAV, HBV, HCV and HEV. No
autoimmune antibodies. Total cholesterol 270 mg/dL, triglyceride 140mg/dL.
Glucose normal. After thre... 阅读全帖 |
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e******e
发帖数: 118 | 45 I have seen a similar case, mid age Asian female w AML, s/p induction in
remission but could not complete consolidation chemo due to many liver
lesions- abscess per image study, multiple biopsy and cultures but not
revealing, treated w many antibiotics and antifungal. don't remember if she'
s febrile then. Eventually discharged home w po antibx, observe for AML and
images to follow up liver change. had a discussion with one of the ID
attending at MDACC who thought the liver lesion might be autoi... 阅读全帖 |
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l*******r
发帖数: 39279 | 46 可粘啊
肩周炎属于autoimmune disease,当气候变化空气里充满水汽，自身免疫力下降时就可
能发作
姐也有肩周炎 |
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l*******r
发帖数: 39279 | 47 是，是autoimmune disease
我是看见佐牙说椎间盘穿刺，所以才问
当年我tmd手扭了，美国的废物医生实在看不出毛病，说我是不是得了MS, 叫我做穿刺
。我就不做，后来自己好了 |
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p****y
发帖数: 23737 | 48 http://www.nytimes.com/2010/11/30/health/30vitamin.html?_r=1&hp
Report Questions Need for 2 Diet Supplements
By GINA KOLATA
Published: November 29, 2010
The very high levels of vitamin D that are often recommended by doctors and
testing laboratories — and can be achieved only by taking supplements —
are unnecessary and could be harmful, an expert committee says. It also
concludes that calcium supplements are not needed.
The group said most people have adequate amounts of vitamin D in their blood... 阅读全帖 |
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发帖数: 5516 | 50 这下热闹了。
四家律师楼一起来。这种诉讼原告有赢的先例吗？
The Law Firm of Levi & Korsinsky Notifies Investors With Losses on Their
Investment in Human Genome Sciences, Inc. of Class Action Lawsuit and
the
Deadline of January 10, 2012 to Seek a Lead Plaintiff Position
NEW YORK, NY--(Marketwire - Nov 16, 2011) - Levi & Korsinsky announces
that
a class action lawsuit has been commenced in the District Court of
Maryland
on behalf of purchasers of Human Genome Sciences, Inc. ("HGS" or the "
Company") (NASDAQ: HGSI) common stock... 阅读全帖 |
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