今天在Office，Dr.Cameron语出惊人，居然发表了一段“Sex could kill you”的comment：
“...Sex could kill you. Do you know what the human body goes through when you have sex?
Pupils dilate, arteries constrict, core temperature rises.
Heart races, blood pressure skyrockets.
Respiration becomes rapid, and shallow.
Brain fires bursts of electrical impulses from nowhere to nowhere.
Secretions spit out of every gland.
And the muscles tense and spasm like you're lifting 3 times your body weight.
It's violent, it's ugly, and it's messy!
And if God hadn't made it unbelievably fun, the human race would've died out eons ago.”

强！这真是典型Asceticism言论。

 

Medical Insight （November 26^th, 2007）

Self-made Audio Programme 23 (本人原声)

you can download this audio material at

http://www.zshare.net/audio/5173706ed0bc45/

 

Welcome to Medical Insight November 26th, 2007, I’m Dr. Alex Roy. This week let’s take a look at a 31-Year-Old Woman  with Rash, Fever, and Hypotension---a case record from the Massachusetts general hospital.

 

A 31-year-old woman was admitted to the hospital because of facial swelling, fever, and hypotension. The patient had relapsing and remitting multiple sclerosis, associated with severe fatigue. Three weeks before the patient presented to the hospital, periorbital眶周erythema红斑, a conjunctival discharge, and a pruritic痒的facial rash developed after she had started taking modafinil兴奋剂莫达非尼. Despite treatment with anti-histamines and corticosteroids, her symptoms persisted. At another hospital, a low-grade fever, left facial swelling, and transient hypotension were noted. She was transferred to this hospital for evaluation of a possible facial abscess. However, her course took an unexpected turn when chest pain developed, ST-segment elevation was present on the electrocardiogram, and biomarkers of cardiac necrosis were elevated. Echocardiography disclosed a pericardial effusion and left ventricular dysfunction. And an endo-myocardial biopsy was performed.

Final Diagnosis: Acute Eosinophilic Myocarditis

 

 

Medical Insight （November 25^th, 2007）

Self-made Audio Programme 22 (本人原声)

you can download this audio material at

http://www.zshare.net/audio/51474615431601/

Welcome to Medical Insight November 25th, 2007, I’m Dr. Alex Roy. Lung transplantation is a treatment used for patients with cystic fibrosis. These authors analyzed a large data set of children with cystic fibrosis who underwent lung transplantation and used proportional hazards modeling to consider the effects of transplantation.

This retrospective study showed that most of the children (509 of the 514 studied and 247 of the 248 patients who underwent transplantation) did not derive a significant survival benefit as estimated in statistical models. Although the majority of patients (315) were at significant risk for harm, for 194 patients, the procedure was not clearly harmful or beneficial. Less than 1% of patients had a significant estimated survival benefit. There were insufficient data to determine whether the procedure improved the patients’ quality of life.

Julian Allen from the Children’s Hospital of Philadelphia, and Gary Visner from the Children’s Hospital, Boston write an editorial that The implications of the current study are that transplantation may not improve survival for children with cystic fibrosis, and if it does, it would be expected to do so only in patients whose predicted 5-year survival is less than 30% or whose predicted median survival is less than 3 years. Patients with cystic fibrosis and their parents need to be informed that although transplantation may improve quality of life, it may not improve survival. This information is sure to make an already difficult decision more difficult still.

Advanced Seconds---《新概念》个人纪录

原磁带录音：2分54秒

个人朗读记录：2分3秒

Advanced Sec：51秒！

Advanced Rate：29.3％

download my record at

http://www.zshare.net/audio/5123035e6863b7/ There has long been a superstition among mariners that porpoises will save drowning men by pushing them to the surface, or protect them from sharks by surrounding them in defensive formation. Marine Studio biologists have pointed out that, however intelligent they may be, it is probably a mistake to credit dolphins with any motive of lifesaving. On the occasions when they have pushed to shore an unconscious human being they have much more likely done it out of curiosity or for sport, as in riding the bow waves of a ship. In 1928 some porpoises were photographer working like beavers to push ashore a waterlogged mattress. If, as has been reported, they have protected humans from sharks, it may have been because curiosity attracted them and because the scent of a possible meal attracted the sharks. Porpoises and sharks are natural enemies. It is possible that upon such an occasion a battle ensued, with the sharks being driven away or killed. Whether it be bird, fish or beast, the porpoise is intrigued with anything that is alive. They are constantly after the turtles, who peacefully submit to all sorts of indignities. One young calf especially enjoyed raising a turtle to the surface with his snout and then shoving him across the tank like an aquaplane. Almost any day a young porpoise may be seen trying to turn a 300-pound sea turtle over by sticking his snout under the edge of his shell and pushing up for dear life. This is not easy, and may require two porpoises working together. In another game, as the turtle swims across the oceanarium, the first porpoise swoops down from above and butts his shell with his belly. This knocks the turtle down several feet. He no sooner recovers his equilibrium than the next porpoise comes along and hits him another crack. Eventually the turtle has been butted all the way down to the floor of the tank. He is now satisfied merely to try to stand up, but as soon as he does so a porpoise knocks him flat. The turtle at last gives up by pulling his feet under his shell and the game is over.

Advanced Seconds---《新概念》个人纪录

 

原磁带录音：2分43秒

个人朗读记录：1分48秒

Advanced Sec：55秒！

Advanced Rate：33.7％

download my record at http://www.zshare.net/audio/5075372c27fc58/

In the early days of the settlement of Australia, enterprising settlers unwisely introduced the European rabbit. This rabbit had no natural enemies in the Antipodes, so that it multiplied with that promiscuous abandon characteristic of rabbits. It overran a whole continent. It caused devastation by burrowing and by devouring the herbage which might have maintained millions of sheep and cattle. Scientists discovered that this particular variety of rabbit (and apparently no other animal) was susceptible to a fatal virus disease, myxomatosis. By infecting animals and letting them loose in the burrows, local epidemics of this disease could be created. Later it was found that there was a type of mosquito which acted as the carrier of this disease and passed it on to the rabbits. So while the rest of the world was trying to get rid of mosquitoes, Australia was encouraging this one. It effectively spread the disease all over the continent and drastically reduced the rabbit population. It later became apparent that rabbits were developing a degree of resistance to this disease, so that the rabbit population was unlikely to be completely exterminated. There were hopes, however, that the problem of the rabbit would become manageable.
Ironically, Europe, which had bequeathed the rabbit as a pest to Australia, acquired this man-made disease as a pestilence. A French physician decided to get rid of the wild rabbits on his own estate and introduced myxomatosis. It did not, however, remain within the confines of his estate. It spread through France, Where wild rabbits are not generally regarded as a pest but as sport and a useful food supply, and it spread to Britain where wild rabbits are regarded as a pest but where domesticated rabbits, equally susceptible to the disease, are the basis of a profitable fur industry. The question became one of whether Man could control the disease he had invented.

 

Medical Insight （November 21st, 2007）

Self-made Audio Programme 20 (本人原声)

you can download this audio material at http://www.zshare.net/audio/50532018c9b4fe/

 Welcome to Medical Insight November 21st, 2007, I’m Dr. Alex Roy.  A 30-Year-Old Man with Inflammatory Bowel Disease and Recent Onset of Fever and Bloody Diarrhea. A case record from Massachusetts General Hospital, Boston

Advanced Seconds---《新概念》个人纪录

 

原磁带录音：2分05秒

个人朗读记录：1分21秒

Advanced Sec：44秒！

Advanced Rate：35.2％

download my record at http://www.zshare.net/audio/5008409eca24d9/

Two factors weigh heavily against the effectiveness of scientific research in industry. One is the general atmosphere of secrecy in which it is carried out, the other the lack of freedom of the individual research worker. In so far as any inquiry is a secret one, it naturally limits all those engaged in carrying it out from effective contact with their fellow scientists either in other countries or in universities, or even, often enough, in other departments of the same firm. The degree of secrecy naturally varies considerably. Some of the bigger firms are engaged in researches which are of such general and fundamental nature that it is a positive advantage to them not to keep them secret. Yet a great many processes depending on such research are sought for with complete secrecy until the stage at which patents can be taken out. Even more processes are never patented at all but kept as secret processes. This applies particularly to chemical industries, where chance discoveries play a much larger part than they do in physical and mechanical industries. Sometimes the secrecy goes to such an extent that the whole nature of the research cannot be mentioned. Many firms, for instance, have great difficulty in obtaining technical or scientific books from libraries because they are unwilling to have names entered as having taken out such and such a book, for fear the agents of other firms should be able to trace the kind of research they are likely to be undertaking.

Medical Insight （November 10, 2007）

Self-made Audio Programme 19

you can download this audio material at

http://www.zshare.net/audio/4804946531f0ff/

 

 

Welcome to Medical Insight November 10, 2007, I’m Dr. Alex Roy.  Bronchopulmonary dysplasia has become the most common chronic lung disease of infancy. A review from University of Padua, Italy summarizes the patterns and pathogenesis of chronic lung impairment that may become clinically significant decades after the use of mechanical ventilation and oxygen supplementation in premature newborns. In premature newborns, the lungs are often exposed to several sources of injury, both before and after birth. Such exposures — as well as genetic susceptibility to problematic lung development — may cause direct airway and parenchymal damage and induce a deviation from the normal developmental path. Depending on the timing and extent of the exposures, lung injury may range from early developmental arrest (the new bronchopulmonary dysplasia) to structural damage of a relatively immature lung (the old bronchopulmonary dysplasia). Premature infants born at gestational age at of 23 to 30 weeks — during the canalicular and saccular stages of lung development — are at the greatest risk for bronchopulmonary dysplasia. Advances in neonatal care have increased survival after preterm birth. Because many of these survivors are now approaching adulthood, family doctors and chest physicians will be seeing more cases of this novel chronic pulmonary disease, which begins in neonatal life.

Advanced Seconds---《新概念》个人纪录

 

原磁带录音：2分33秒

个人朗读记录：1分32 秒

Advanced Sec：61秒！

Advanced Rate：39.87％

download my record at http://www.zshare.net/audio/4783434562d396/

Beyond two or three days, the world's best weather forecasts are speculative, and beyond six or seven they are worthless.
The Butterfly Effect is the reason. For small pieces of weather -- and to a global forecaster, small can mean thunderstorms and blizzards -- any prediction deteriorates rapidly. Errors and uncertainties multiply, cascading upward through a chain of turbulent features, from dust devils and squalls up to continent-size eddies that only satellites can see.
The modern weather models work with a grid of points of the order of sixty miles apart, and even so, some starting data has to guessed, since ground stations and satellites cannot see everywhere. But suppose the earth could be covered with sensors spaced one foot apart, rising at one-foot intervals all the way to the top of the atmosphere. Suppose every sensor gives perfectly accurate readings of temperature, pressure, humidity, and any other quantity a meteorologist would want. Precisely at noon an infinitely powerful computer takes all the data and calculates what will happen at each point at 12.01, then 1202, then 12.03...
The computer will still be unable to predict whether Princeton, New Jersey, will have sun or rain on a day one month away. At noon the spaces between the sensors will hide fluctuations that the computer will not know about, tiny deviations from the average. By 12.01, those fluctuations will already have created small errors one foot away. Soon the errors will have multiplied to the ten-foot scale, and so on up to the size of the globe.

Advanced Seconds---《新概念》个人纪录

 

原磁带录音：2分07秒

个人朗读记录：1分08 秒

Advanced Sec：59秒！

download my record at

http://www.zshare.net/audio/4708005a10f99b/ The deepest holes of all made for oil, and they go down to as much as 25,0000 feet. But we not need to send men down to get the oil our, as we must with other mineral deposits. The holes are only borings, less than a foot in diameter. My particular experience is largely in oil, and the search for oil has done more to improve deep drilling than any other mining activity. When is has been decided where we are going to drill, we put up at the surface an oil derrick. It has to be tall because it is like a giant block and tackle, and we have to lower into the ground and haul out of the ground great lengths of drill pipe which are rotated by an engine at the top and are fitted with a cutting bit at the bottom. The geologist needs to know what rocks the drill has reached, so every so often a sample is obtained with a coring bit. It cuts a clean cylinder of rock, from which can be seen the strata the drill has been cutting through. Once we get down to the oil, it usually flows to the surface because great pressure, either from or water, is pushing it. This pressure must be under control, and we control it by means of the mud which we circulate down the drill pipe. We endeavour to avoid the old, romantic idea of a gusher,  which wastes oil and gas. We want it to stay down the hole until we can lead it off in a controlled manner

Medical Insight （November 5, 2007）

Self-made Audio Programme 18 (本人原声)

you can download this audio material at

http://www.zshare.net/audio/4690367acb5502/

Welcome to Medical Insight November 5, 2007, I’m Dr. Alex Roy.  This week we will take a look at a Multifunctional Cytokine--- Leukotrienes.

Leukotrienes (“leuko,” from white blood cells; and “trienes,” three conjugated double bonds) comprise a family of products of the 5-lipoxy-genase pathway of arachidonic acid花生四烯酸 metabolism. There are lipid mediators with a broad array of clinical effects, the cysteinyl半胱氨酰leukotrienes C4, D4, and E4 account for the biologic activity that was previously termed “slow-reacting substance of anaphylaxis,” and the efficacy of antagonists to type 1 cysteinyl leukotriene receptor in asthma validates that the importance of cysteinyl leukotrienes and its receptor in this disease. Today, nearly three decades since leukotrienes were discovered and one decade since drugs targeting this pathway became available, new and often unexpected insights into the biology and clinical importance of these lipid mediators continue to emerge. Beyond the classically recognized and validated participation of cysteinyl leukotrienes in asthma, it is now evident that leukotrienes are multifunctional mediators that influence many biologic responses and probably play a role in other diseases. This review of leukotrienes and leukotrienes receptors considers the biochemical and physiological aspects of these molecules, examines their roles in asthma and other diseases, and explains the pharmacologic effects of anti-leukotriene agents.