56例老年胃食管反流病误诊分析

胃食管反流病（GERD）是由多种因素造成的消化道动力障碍性疾病,临床表现复杂,常涉及多个系统,容易被误诊。2005年6月-2008年6月,我们对曾被误诊为其他疾病的56例不典型GERD误诊原因进行回顾性分析。现报告如下。     

肤源性消化道出血

消化道出血的原因以溃疡病、出血性胃炎、食管胃底静脉曲张破裂和胃肠道肿瘤及结肠炎性疾病、息肉多见,由胰腺疾病引起者较少。为提高认识,减少漏诊、误诊,本文综述胰源性消化道出血的病因、临床表现及诊断和治疗要点。     

慢性胃扭转8例误诊分析

胃扭转多具有病程长、症状轻和反复发作的特点,其症状与溃疡病、消化道肿瘤、慢性胃炎等消化系疾病极相似,故易造成误诊。近年来,我们将8例慢性胃扭转误诊为其他疾病,现报告其中4例。1、误诊为消化道肿瘤:患者男,68岁。     

肾脏疾病的神经系统障碍

各系统各器官的疾病均可直接或间接地引起神经系统的障碍或病理损害。如肺功能不足导致二氧化碳滞留而产生脑病,心脏瓣膜病变引起脑栓塞,心力衰竭产生脑缺氧,消化道疾病引起神经系统营养缺乏性疾病,內分泌、肾脏疾病产生神经并发症等绻雎?往往导致误诊误治。本笔谈对呼吸、消化、心血管、肾脏及内分泌系统的神经并发症作了比较全面、深入的探讨。     

心脑综合征的病因与诊断

各系统各器官的疾病均可直接或间接地引起神经系统的障碍或病理损害。如肺功能不足导致二氧化碳滞留而产生脑病,心脏瓣膜病变引起脑栓塞,心力衰竭产生脑缺氧,消化道疾病引起神经系统营养缺乏性疾病,內分泌、肾脏疾病产生神经并发症等绻雎?往往导致误诊误治。本笔谈对呼吸、消化、心血管、肾脏及内分泌系统的神经并发症作了比较全面、深入的探讨。     

酒精中毒性运动障碍

各系统各器官的疾病均可直接或间接地引起神经系统的障碍或病理损害。如肺功能不足导致二氧化碳滞留而产生脑病,心脏瓣膜病变引起脑栓塞,心力衰竭产生脑缺氧,消化道疾病引起神经系统营养缺乏性疾病,內分泌、肾脏疾病产生神经并发症等绻雎?往往导致误诊误治。本笔谈对呼吸、消化、心血管、肾脏及内分泌系统的神经并发症作了比较全面、深入的探讨。     

内分泌疾病的神经精神障碍

各系统各器官的疾病均可直接或间接地引起神经系统的障碍或病理损害。如肺功能不足导致二氧化碳滞留而产生脑病,心脏瓣膜病变引起脑栓塞,心力衰竭产生脑缺氧,消化道疾病引起神经系统营养缺乏性疾病,內分泌、肾脏疾病产生神经并发症等绻雎?往往导致误诊误治。本笔谈对呼吸、消化、心血管、肾脏及内分泌系统的神经并发症作了比较全面、深入的探讨。     

心力衰竭与脑缺血,缺氧

各系统各器官的疾病均可直接或间接地引起神经系统的障碍或病理损害。如肺功能不足导致二氧化碳滞留而产生脑病,心脏瓣膜病变引起脑栓塞,心力衰竭产生脑缺氧,消化道疾病引起神经系统营养缺乏性疾病,內分泌、肾脏疾病产生神经并发症等绻雎?往往导致误诊误治。本笔谈对呼吸、消化、心血管、肾脏及内分泌系统的神经并发症作了比较全面、深入的探讨。     

呼吸系疾病对神经系统的影响

各系统各器官的疾病均可直接或间接地引起神经系统的障碍或病理损害。如肺功能不足导致二氧化碳滞留而产生脑病,心脏瓣膜病变引起脑栓塞,心力衰竭产生脑缺氧,消化道疾病引起神经系统营养缺乏性疾病,內分泌、肾脏疾病产生神经并发症等绻雎?往往导致误诊误治。本笔谈对呼吸、消化、心血管、肾脏及内分泌系统的神经并发症作了比较全面、深入的探讨。     

消化系统疾病的神经症状

各系统各器官的疾病均可直接或间接地引起神经系统的障碍或病理损害。如肺功能不足导致二氧化碳滞留而产生脑病,心脏瓣膜病变引起脑栓塞,心力衰竭产生脑缺氧,消化道疾病引起神经系统营养缺乏性疾病,內分泌、肾脏疾病产生神经并发症等绻雎?往往导致误诊误治。本笔谈对呼吸、消化、心血管、肾脏及内分泌系统的神经并发症作了比较全面、深入的探讨。     

State of knowledge of helminth fauna of freshwater fishes of Poland

A total 89 fish and lamprey species has been recorded from Polish freshwater habitats. Twenty-seven of them (30.3%) have not been surveyed for parasitic helminthes. Some of the latter fishes are either rare or not easily accessible. Other live only in specific habitats in scattered localities. An important obstacle for studying parasite faunas of some fishes may be their status on an endangered species. Among the non-surveyed fishes, are those which have been relatively recently introduced to Poland or migrated there on their own. The present paper attempts to review all hitherto not studied helminthologically fish species, their habitats, localities and current protection status.     

高血压降压治疗目标的再认识

根据传统的高血压水平的定义,1993年WHO高血压治疗指南提出血压控制目标为<140/90mm Hg(1mm Hg=0.133kPa),但是并非所有患者都必须将血压降至同一水平,而应根据患者情况进行个体化治疗。Framingham进行的一项长达10～12年的心血管事件研究发现,第5年后,正常上限血压[收缩压(SBP     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.