查看完整版本: 〖原创〗医学生眼中的《House M.D.》S1EP02

〖原创〗医学生眼中的《House M.D.》S1EP02

今天的故事其实说到底就是关于免疫的问题，虽然题目是PATERNITY(父子关系)。

棒球运动员的怪异的疾病是由于早期的麻疹病毒躲到大脑里潜伏起来然后在16年后造成了巨大的影响。

说到这里，就不得不说一下House说的那个从母亲带来的持续6个月的免疫能力，这个称为天然被动免疫，指母体抗体经胎盘传给胎儿,或经初乳传给新生儿,使之获得免疫，如新生儿及头 6个月的婴儿对某些传染病(如麻疹、白喉)有免疫力。此种免疫无特异性，维持时间短。所以如果母亲有此类抗体，则婴幼儿可以借此来获得免疫能力。但是这种免疫并不是万能的。在胚胎发育的时候，A，D，E，G，M这么众多类的抗体中仅有抗体G(也就是通常说的IgG，是抗体中的一大类)，能通过母体和胎儿之间的血胎屏障(这就是通常说的胎盘)。所以，有些特定的抗体不能到达胎儿的体内。

再说说疫苗。House用一种正话反说，带着不可置疑的语气，甚至带有点威胁恐吓的方法终于说服了那位认为所谓的跨国公司生产的疫苗只不过是为了赚钱的母亲给孩子打上疫苗。

疫苗是一种好东西，可以给我们的身体带来一段时期(虽然存在个体差异和不同品种的差异，但一般都比较长)对某种疾病的免疫能力。目前我们国家给儿童预防接种的疫苗分为两类。第一类是计划免疫疫苗，第二类是自费疫苗。第一类疫苗由政府出资，包括卡介苗，脊髓灰质炎疫苗，麻疹疫苗，新生儿用乙型肝炎疫苗等。

再讲讲那“万能”的青霉素。为什么在前面的治疗中青霉素直接注射到脑脊液中没有效果呢？这并不是因为青霉素没有达到病灶。而是因为青霉素是属于抗生素类药物，而抗生素类药物最主要的是作用于细菌感染，几乎对病毒没有效果。而这次的病原正是麻疹病毒。而目前存在的迫在眉睫的耐药性也主要是由于抗生素滥用而引起的。众多的耐药菌的出现已经使得抗生素越来越无力面对了。而且面对病菌的时候，也不是越广谱的越好。越有针对性越适当地用药可以使得病菌得到最彻底的消灭。

而House最后对患者的治疗是用了干扰素，这个是目前来说对病毒还是比较有效的方法。它主要作用于DNA复制时期，干扰DNA的正常复制，所以往往对人体也有害，像这种直接注入脑室的方式也是很危险的。像现在治疗乙型肝炎，AIDS的时候都有干扰素的身影存在。

[color=RoyalBlue][align=center]--==截止2007/02/20==--[/align][/color]

附EP02的剧情梗概
S1EP02
PATERNITY
Aired 11/23/04
A family arrives for an appointment with House even though it’s a walk-in clinic. They 11:01 2007-2-19claim to have a letter from him about the appointment, which is odd because House doesn’t write letters. It seems that Dr. Cameron wrote the letter and signed House’s name to aid the family.

House agrees to see the patient. Dan is a 16-year old who has the sudden onset of double vision and night terrors. House says that post-traumatic stress and sexual abuse are two common symptoms. Dan, a high school lacrosse player, admits that he was recently struck in the head. House tells the kid to get some glasses to correct the double vision and ride out the concussion that’s causing the night terrors.

As the kid is leaving, House notices Dan’s foot twitch and he asks if he’s tired or about to fall asleep. He isn’t, and House knows the myoclonic jerk is common when a person is falling asleep. The body misinterprets a falling pulse as dying and jolts you awake. House instructs his staff to admit the patient.

House bets Dr. Foreman that the dad isn’t Dan’s biological father. They can’t rule out genetic causes just yet. During the first night, the patient has another night terror, which is recorded on a polysonagraph. But a series of scans and tests show no explanation for the symptoms. House re-examines the MRI and orders another test that shows there is significant blockage. A shunt is inserted to relieve the pressure. After surgery, it turns out what they thought was the issue was only a symptom of something larger. Is it Multiple Sclerosis?

That night, Dan goes missing from his bed. Cameron, Chase and Foreman set off on a search, eventually finding Dan on the roof. Dan thinks he’s on the lacrosse field walking around. The doctors tackle him moments before he wanders off the edge of the roof.

The next morning, House is confused by Foreman’s report from the roof. House is thrilled because this means Dan doesn’t have night terrors -- and thus, is not suffering from MS. Dan must have an infection in his brain, which House thinks is neurosyphillis.

As Cameron and Chase inject penicillin into Dan’s brain, he begins having another attack of voices in his head. The auditory hallucination disproves neurosyphillis. House orders more tests to read Dan’s brain. He notices that the parents have left their lunch behind in the hospital, so House takes a sample to run a DNA test. Cameron finds that neither of them are Dan’s biological parents. He’s adopted. Was his birth mother vaccinated? House thinks infant Dan caught a basic measles virus that mutated and reappeared 16 years later after settling into his brain. He suggests injecting a needle into the boy’s eye to do a biopsy on his retina.

That frightening test reveals the mutated virus which requires a dangerous brain surgery. However, the surgery if effective and Dan will be fine. Turns out Dan already knew he was adopted after doing his own research in the fifth grade.

还好我的免疫学过了··· 不过我相当讨厌这些科目。。
阿昔洛韦，利巴韦林，无环鸟苷。。。。。
最后一段让我想起了化疗:O)
LZ临床啊··

:O) 不懂

恩，临床~~

阿昔洛韦，利巴韦林，无环鸟苷，这些都是鸡尾酒疗法里的常用药。。。什么齐拉夫定，扎西他滨的。。。

我看到IGG IGM就头疼。。。
啥子抗体抗原整完了。。
郁闷ING。

我看着也头大。。。:O)

考试1过，东西都基本忘记了。。
等考执业医师时候又要使劲背书了。。
现在基础课程都基本记不到了，就会专业科目了。:o)
不过说起疫苗，好像我小时候少打了1种。。具体是什么我也忘记了。。
那天打针，，我跑去玩了··:O)

浪浪什么时候去考？
我现在刚读了2年半，大概还有一年多才能去考吧？

汗，做医生的得认真啊。。

明年··

后续的评论呢?
非医学专业的人等着看~~~~~~~:O)

为什么在前面的治疗中青霉素直接注射到脑脊液中没有效果呢？

强大啊， 刚看完第一季第二集，外行人只能看热闹了，刚开始看，有点难跟着House的节奏

:O)  路过......

[quote]原帖由 [i]astsdl[/i] 于 2007-3-16 07:45 发表 [url=http://itbbs.pcshow.net/redirect.php?goto=findpost&pid=4411727&ptid=350879092][img]http://itbbs.pcshow.net/images/common/back.gif[/img][/url]
为什么在前面的治疗中青霉素直接注射到脑脊液中没有效果呢？ [/quote]
LZ说了嘛···
青霉素是抗生素。。针对细菌的。。
而帖子所说的感染是病毒····
我现在就想起1个，金刚烷胺。:O)