糖尿病皮肤病变

精尿病患者皮肤受累非常普遍,其皮肤损害表现多种多样,主要包括与糖尿病有父的皮肤病变、皮肤感染、精尿病并发症的皮肤病变及糖尿病治疗的皮肤反应.糖尿病皮肤病变的发病机制尚不清楚.治疗的关键是控制血糖,使血糖达标,针对不同的病因及皮损表现采取相应的处理.     

糖尿病皮肤功能障碍及其机制的研究进展

糖尿病皮肤病变是最常见但最容易被忽视的糖尿病并发症之一, 严重影响患者的生存质量, 甚至导致糖尿病足的发生。近年来研究提出, 糖尿病皮肤病变可在一定程度上预测糖尿病并发症的进展、糖尿病足的发生, 因此对于糖尿病皮肤病变的早期诊断及治疗具有重要意义。但目前关于糖尿病皮肤病变的发病机制仍未完全阐明, 糖尿病皮肤病变的早期防治也未引起临床上的重视, 因此不乏见到因皮肤病变导致严重糖尿病足并最终截肢的病例。该文结合国内外最新进展, 从皮肤结构、慢性炎症损伤、皮肤微环境等方面, 归纳总结糖尿病患者皮肤病变的病理生理改变, 探讨糖尿病皮肤功能障碍潜在的发病机制, 阐述皮肤微生态对于糖尿病皮肤病变的影响, 为糖尿病皮肤病变的早期诊断和治疗提供理论依据。     

糖尿病合并皮肤病36例临床分析

据报道 ,30 %的糖尿病患者可有皮肤损害 ,糖尿病患者确诊前 ,常因皮肤症状就诊皮肤科。1998～ 2 0 0 2年 ,我院确诊糖尿病合并皮肤病 36例 ,现报告如下。临床资料 :本组男 14例 ,女 2 2例 ;平均年龄 6 5 .8( 4 1～90 )岁 ,平均病程 15 .8( 4个月至 8年 )个月。8例表现为全身皮肤干燥、粗糙、阵发性瘙痒 ,瘙痒以夜间为重 ,无原发性皮损 ,仅见患处皮肤抓痕、表皮剥脱、血痂及色素沉着 ,病程较长者局部呈苔藓样变 ;11例表现为外阴部反复发作性剧痒 ,局部粘膜皮肤肥厚、浸润、苔藓样变或色素改变 ,14例念珠菌性阴道炎、龟头炎 ,表现为女性阴道粘…     

消化系统疾患的皮肤病症

伴随体内脏器疾患的一些特定皮肤病变称为内脏疾患的皮肤病症。这些皮肤病症往往成为重要的内脏疾患早期诊断的线索,且对治疗和预后的判定有一定价值,本文综述了与消化系统疾病相关连的皮肤病变,包括发生于消化系统和皮肤的损害,全身性疾病引起的消化系统和皮肤的损害,继发于消化系统疾患的皮肤损害及继发于皮肤病变的消化系统障碍等方面。并对于消化系统恶性肿瘤相关连的皮肤病变及与皮肤病变相关连的消化道出血作了简要说明。     

中医专家为您诠释糖尿病皮肤病变：糖尿病皮肤病变与中医治疗

糖尿病患者可出现多种皮肤病变，发生率高达30％。这些病变可在全身任何部位皮肤发生，见于糖尿病的各个时期。糖尿病皮肤病变的发病机制复杂，可由微血管病变、神经病变、代谢异常和皮肤感染等因素单独或相互作用而引起。中医辨证虽呈现多证相兼、证候复杂特征，但血瘀证常常是糖尿病皮肤病变中的主要证候。     

皮肤神经活检对糖尿病周围神经病的早期诊断价值

目的初步探索皮肤神经活检对糖尿病周围神经病的早期诊断价值。方法收集糖尿病患者及正常人皮肤标本各43例,通过皮肤神经活检对其皮肤神经纤维进行定量和形态学分析,采用PGP 9.5免疫组织化学染色和胆碱酯酶组化染色,使用C5型目镜测微尺镜下观察表皮神经纤维分布的特点和规律,使用Image-Pro Plus 6.0图像分析软件分析汗腺神经分布情况。结果与正常人比较,糖尿病患者的表皮神经纤维密度明显减少,分布稀疏,走形扭曲;支配汗腺的胆碱能神经数量明显减少,染色浅淡,密度不均,部分汗腺区胆碱能神经纤维消失。结论糖尿病患者的表皮神经和汗腺神经多有不同程度的损伤,说明其存在不同程度的末梢神经损害,这种损害已经存在于无周围神经损伤症状的糖尿病患者中,对糖尿病周围神经病具有早期诊断的价值。     

糖尿病瘙痒症的中医防治

糖尿病瘙痒症是糖尿病皮肤病的一种，常发生于息病之后，也有一些于患病前发生。资料表明，约30％的糖尿病患者会发生各种皮肤病，而皮肤病的发生与发展又能加重糖尿病病情，因此防治皮肤病对控制血糖非常重要。皮肤瘙痒可分为多发性与局限性两种，前者呈广泛性瘙痒，无原发损害，可同时发作，也可从一处延至另一处，     

皮肤病的胃肠道表现

内脏病和皮肤疾病可以共存是人所熟知的.但对某种皮肤病能引起消化道疾病这点则未必了解.肠、皮肤联系相当常见.影响到胃肠道的多种先天性和遗传性损害的特征可由皮肤表现出来.兹将某些皮肤病的胃肠道表现叙述如下:银屑病:在本病中吸收不良性肠病发生率颇高,但与皮肤受累的程度无关.虽常无明显肠     

如何做好日常皮肤护理

糖尿病患者应像重视心脑肾眼足等并发症一样重视皮肤病变。尤其夏季炎热，皮肤感染高发，易诱发溃疡，严重者并发足部病变。因此患者朋友要注意做好皮肤清洁工作，加强润肤护理。如果您能够科学管理糖尿病，认真护理皮肤，大部分皮肤病变是可以预防的。     

糖尿病皮肤病变

糖尿病时由于胰岛素相对或绝对不足,糖、脂肪及蛋白质代谢明显紊乱,与全身其他组织器官一样,皮肤也是受累器官之一。糖尿病皮肤表现种类多,发病率高(见附表)。在原发性糖尿病中,皮肤病变就有10数种,约20～50%患者发生1种或几种皮肤表现。其中某些病变系糖尿病的特异表现,与大血管及微血管病变、代谢紊乱、神经病变等有直接关系;另一些虽无特异性,系全身代谢紊乱的后果,但却能促使糖尿病显现和恶化,对糖尿病早期发现及     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.