x*****o
发帖数: 135 | 1 谢谢大家.我也注意到这两个药了,SUTENT和GLEEVE合用对付GIST,估计治不了
adenocarcinoma(腺癌).AVASTIN好像毒性很大,导致GI perforation的,我实在不敢介绍
呀.看来现在新的ONCOLOGY的药也就是拣拣好治的病治治,真正nasty的case也没什么办
法. |
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s********4
发帖数: 64 | 2 CC: Axillofemoral bypass surgery for an occluded right limb
HPI: 62 yo male with antiphospholipid syndrome presents to VAMC for
scheduled axillofemoral bypass surgery on 10/22. Patient was instructed to
hold warfarin and start enoxaparin for bridging prior to surgery. Patient
was admitted pre-op on 10/21 and switched to a heparin drip for
anticoagulation. Surgery was completed successfully with no complications
on 10/22. Post operatively patient feels much better with minimal pain in
his fo... 阅读全帖 |
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d*******2
发帖数: 340 | 3 http://www.edphoton.com/en
Wuxi OptonTech Ltd. specialises in diffractive optical elements (DOEs) and
computer generated holograms (CGHs) for flat-top (also referred to as top-
hat or super-Gaussain) beam shaping and other general beam shaping, beam
splitting, beam homogenizing (diffusing). Examples of general beam shaping
include multi-line patterns, square, view finder, crosshair, grids, rings,
etc. Typical applications of DOEs include phase gratings for optical linear
encoders, DOEs for motio... 阅读全帖 |
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a*i
发帖数: 1652 | 4 http://247wallst.com/2011/07/18/the-eleven-most-implanted-medic
11. Implantable Cardioverter Defibrillators
> Number of procedures: 133,262
> Total annual expenditure: $5.5 billion
> Average cost per procedure: $40,000
> Major manufacturer: Medtronic (40%), St. Jude Medical, and Boston
Scientific
Cardiac arrhythmia, or improper electric signaling in the heart, occurs in
millions of people a year. While the vast majority are benign, a select few
— usually in patients with a history of heart attac... 阅读全帖 |
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y***d
发帖数: 33 | 5 在板上潜水有一会了，好像发case的不多啊。是不是这儿attending太多，都没时间写
case了呢？我来抛砖引玉好了。
从今天开始，每星期我会上一个case。 周一history, 周二physical， 周三initial
labs/work up, 周四additional work-up, 周五final diagnosis. 欢迎大家跟贴讨论
。这些case基本上是面向内科resident的。不过attending们也可以复习一下哈。如果
受欢迎的话我会一直贴下去。废话到此为止。 先上第一个case试试反响如何。
CC: bilateral leg swelling and diarrhea
HPI: 72 yo f h/o HTN, diarrhea and pneumatosis intestinalis of unclear
etiology presented to ER for worsening bilateral lower extremity edema and
ongoing diarrhea.
Initially presented 2 month PT... 阅读全帖 |
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y***d
发帖数: 33 | 6 Glad there's a lot of discussion already.
Exam:
T 36.4 P 78 BP 149/87 RR 16 O2sat 98% RA
Gen – NAD
HEENT: NCAT, neck supple, EOMI, o/p clear
CV – RRR, no m/r/g, no JVD
Resp – CTA b/l, no c/r/g
Abd – hyperactive BS, soft, NT, some distension, no HSM
Ext – 4+ pitting edema up to low back. Some scaling and mild erythema noted
on bilateral lower shins.
Neuro – A&Ox3, grossly nonfocal
And to answers some questions posted above:
1. Exploratory laparoscopy showed pneumatosis intestinalis of termina... 阅读全帖 |
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L*****r
发帖数: 722 | 7
aquafina111、mapleleaf16 、SUMO2009及潜水围观的众姐姐们（我也学会了-- 学好不
容易，学这快着呢），像你们这样才貌双全、色艺双绝的医坛佳丽，挤在围观群众里面
，岂不太委屈了？你们的位置，应该在T形台上的水银灯影里，应该是万人瞩目的中心
焦点；也只有你们，才够资格做得众多海龟海鸥海带海豚海鸟海牛旱鸭子们人生价值的
最终裁判。辛苦一趟吧，如果没有你们的兰质慧心予以裁夺，那么众多海洋生物的价值
和使用价值将如体现呢？请注册个马甲，戴上若隐若现神秘的面纱，或者就大度雍容的
展示你美丽的本来面目，做一回海企鹅们翘首以待、retinal perforation 患者们望穿
双眼的女嘉宾吧！ |
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L****n
发帖数: 12932 | 8 i do like to know your reference regarding :"发生肠麻痹的机率是很高的。真发
more likely from bowel perforation (肠穿孔), rather than bowel paralysis.
and the former can be treated with npo/tpn/rectal decompression.
实际的问题就是， 没有确诊（活检）， 仅靠临床诊断是否需要手术。 algorithm 的
下面是if this is emergency (bowel extention, sign of rupture etc)-if no,
observe then biopsy。megacolon is only in 25% of all newborn intestinal
blockage. if yes, whether can be relieved conservatively (fleet enema,
rectal tube etc), if no, surgery, if yes go ... 阅读全帖 |
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g*****d
发帖数: 991 | 9 Sorry for the loss.
Actually, the mortality rate of GI perforation is relative high, around 20-
40%. Every hour delay will increase mortality about 8%.
That is even worse than the heart attack. |
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j****2
发帖数: 3211 | 10 前不久有人发帖我回帖说到过这个问题，美国有的方法国内都有，但是很多国设备有限
，医生还是先用传统的stripping。美国有三种：laser oblation， radiofrequency
oblation， chemical injection closure. 对象：great saphenous vein, small
saphenous vein, anterolateral accessory vein and perforators.
Laser针对large veins，效果好，复发率底，但是时候淤青严重。
radiofrequency 针对直道血管至少7cm长才可以，太弯曲的不行，
chemical injection比较少用，术后皮肤变色回复比较久。
sclerotherapy治标不治本，一般术后处理不消除小血管的。 |
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x*****n
发帖数: 3422 | 11 stock组可以改front sway和link，不可以动rear sway (我也不知道为什么不让改rear
sway)
可以改shocks，一定要原厂spring。（所以那几个特殊版本的miata吃香）
pad随便，我总觉得我的车brake bias太靠前，就按照miata.net的人的说法，前oed后
第三方
不能换排气，不能换intake。
你如果跑正式SCCA规则的stock组应该用光头胎的。
我们这里有一种特殊组别，算是stock+road tire，所以我用maximum summer
perforance，石桥RE10是老胎了，现在是RE-11
http://www.tirerack.com/tires/tires.jsp?tireMake=Bridgestone&ti
你要是一开始不打算投入太大，就找副二手光头胎先玩起来。front sway便宜也好弄，
什么时候高兴了就换掉。玩了high了再折腾shocks。
stock组的好处是改装余地不大，所以咱们的和高手的车区别不那么大，区别主要还是
在人上，有参照才有学习有进步 |
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g******s
发帖数: 174 | 12 刚在edmund 上面search了一下dealer，有一个马上就给我打电话了，说有一辆2011 328i $36,900，还要我去test drive. 但是她说现在手上没有invoice price，不能告诉我。 我去他们的网站上看了，那个车列了一堆参数，我也没有什么经验，大家能不能帮我看看这个怎么样啊？谢谢！
Technical Specifications
POWERTRAIN
Engine liters: 3.0
Torque: 200 lb.-ft. @ 2,750RPM
Cylinder configuration: I-6
Variable valve control
Fuel economy highway: 28mpg
Manual-shift auto: STEPTRONIC
Sequential multi-point fuel injection
Variable intake manifold
Number of valves: 24
Recommended fuel: premium unleaded
Transmission: 6 speed autom... 阅读全帖 |
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w*******y
发帖数: 60932 | 14 Use coupon "special 15"
I think stock may be limited on both, so this is a overall ymmv deal.
Skechers Girls' Pretty Talls - Fire Star (Toddler-Youth) These light up Fun!
****please note, if you switch the 'white' color over to the other shoe
under 'colors available' (one has teal trim, one has pink) you will find
more sizes.****
Pink trim sizes 10.5-12.5
Teal trim sizes 11.5,12, 12.5 *teal seems to have more stock*
Link:
http://www.shoemall.com/product/Skechers-Girls-Pretty-Talls---Fire-Star-(... 阅读全帖 |
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w*******y
发帖数: 60932 | 17 Link:
http://www.amazon.com/Sesame-Street-Friends-Stained-Coloring/dp
Editorial Reviews
Product Description
What are friends for? To have fun with, of course! Little Sesame Street
fans can go camping with Bert and Ernie, rollerskate with Big Bird, play the
guitar with Grover, plant a garden with Elmo and Telly, and more. Each of
the 16 translucent sheets are perforated for easy removal.
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w*******y
发帖数: 60932 | 18 This deal is back now. I searched and could only find the most previous
expired deal of 11/10/2010 by nikki6kix here http:// />
I'm going with a 20 off 75 break room & cleaning coupon that I just received
to get this for $59.92. Or if you want to go the other route and use a 25
off 75 online or phone coupon to get the 8 cases =ing 96 big rolls that's
suppose to = 128 rolls you can get them for for $54.92 .
Hope this helps 's save a little more
Brawny 12 pack at Staples
Link:
http://www.staples.c... 阅读全帖 |
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w*******y
发帖数: 60932 | 19 Link:
http://www.newegg.com/Product/Product.aspx?Item=N82E16811129066
PROMO CODE: EMCKBHE23
Antec 300 vs Antec 300 Illuminate? Free fans.
Product Description
Antec combines size, quality, features and low price to deliver a
spectacular gaming case. The smallest of Antecs Hundred series is designed
for the Do-It-Yourself gamer. It's equipped to deal with the increased heat
of high-performance systems as well as providing a flexible design. Its
overall matte-black finish shows that you and your s... 阅读全帖 |
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w*******y
发帖数: 60932 | 20 MotorcycleGear.com just put up their Cortech by Tour Master Piuma leather
jacket on closeout for $135 with free shipping. The normal MSRP for it is $
280. I don't have this particular jacket, but I do have two other jackets
from Tour Master and I quite love them.
Link:
http://www.motorcyclegear.com/street/closeouts/leather_suits_ja
This definitely isn't a winter riding jacket, as it is perforated, but it is
a pretty good deal.
They currently have sizes Medium to XXXL in stock.
For those unaware,... 阅读全帖 |
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w*******y
发帖数: 60932 | 21 Link:
http://home.woot.com/
These bamboo kitchen accessories should make you feel at home.
Gerald, I'm just so happy you're here! When your little plane went down over
China and the search party couldn't find anything, I gave up all hope! It
was so sad! But now, finding out that you survived and have been living
these last seven years among the panda bears, why, it's a miracle!
But still, I understand that much of this seems very strange to you: the
electricity, the plumbing, the four walls. I d... 阅读全帖 |
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w*******y
发帖数: 60932 | 23 Amazon. AXO Striker Motorcycle Riding Boots $ 69.99 Free 2 day shipping
with Amazon Prime. Eligible for free super saver shipping.
Link:
http://www.amazon.com/gp/product/B004QPK4JM/
Product Features
Simple-to-use Boa closure system provides a secure fit
Durable outer made with PU-coated synthetics, perforated and solid material
panels, and molded rubber allowing a unique fit
Pressure-molded suede leather supports ankle and rear of the boot
Rubber toe cap allows dirt and frontal debris to simply... 阅读全帖 |
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w*******y
发帖数: 60932 | 24 Staples just sent out coupons via email for $10 off $30 and free Nature
valley Granola Bars with $30 purchase. So check your emails!!!
I bought
Item 478201
Model 3353000
Nature ValleyOats & Honey Granola Bars, 18 Packs/Box
Price:
$11.99
Item 854955
Model PGC 28322
BountyBasic Perforated Paper Towel Rolls, Qty: 3
Price:
$35.97
Item 202580
Model 90135
WindexGlass Cleaner Spray, 32 oz.
Price:
$3.99
Total $51.94
After coupons
21.94 shipped!
Thought this was a pretty good deal so hope... 阅读全帖 |
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v******a
发帖数: 45075 | 25 如果每天超过50，70迈的commute, 除了performance，舒适还是要考虑的。再说perfor
mance也得有条件，曾经有部法拉利被我很WS地憋的没脾气 呵呵 |
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g******s
发帖数: 174 | 26 刚在edmund 上面search了一下dealer，有一个马上就给我打电话了，说有一辆2011 328i $36,900，还要我去test drive. 但是她说现在手上没有invoice price，不能告诉我。我去他们的网站上看了，那个车列了一堆参数，我也没有什么经验，大家能不能帮我看看这个怎么样啊？谢谢！
Technical Specifications
POWERTRAIN
Engine liters: 3.0
Torque: 200 lb.-ft. @ 2,750RPM
Cylinder configuration: I-6
Variable valve control
Fuel economy highway: 28mpg
Manual-shift auto: STEPTRONIC
Sequential multi-point fuel injection
Variable intake manifold
Number of valves: 24
Recommended fuel: premium unleaded
Transmission: 6 speed automa... 阅读全帖 |
|
