糖尿病的胃肠并发症

目前，随着糖尿病患者的增加，糖尿病胃肠并发症越来越常见，这些并发症及其症候通常是由胃肠运动异常引起，常与胃肠道神经病变相关。有研究表明，糖尿病自发神经病变与糖尿病的持续时间有关，但糖尿病控制及并发症的临床试验表明，1型糖尿病患者其神经和胃肠并发症与血糖控制不良有关，与患者持续时间并无必然联系。糖尿病引发的胃肠异常通常可见胃轻瘫、肠下垂（可导致腹泻、便秘和排便失禁）以及非酒精性脂肪肝。     

Migrating transient osteoporosis of the hip in a 30-year-old man

Transient osteoporosis of hip is a condition of unknown etiology, presenting as painful limping, and characterized by osteopenia of the involved joint without preexisting disease or immobilization. Most of the cases were reported in middle-aged men, and one-third of the cases develop in women in the third trimester of pregnancy. The hypothesis that this condition leads to avascular necrosis of the hip has been disproved by various reports and hence does not warrant any surgical interference. This is a self limiting condition, which needs regular follow-up. The authors report a case of migrating transient osteoporosis of the hip in a 30-year-old man successfully treated with antiresorptive treatment.     

74例血友病B患者FⅨ基因突变研究

目的 研究导致中国人血友病B的凝血因子Ⅸ（FⅨ）基因突变类型的分布,并比较与美国白种人群有何异同。方法 从患者外周血白细胞抽提基因组DNA,分9段扩增Ⅸ基因外显子序列,用基因扩增转录测序技术直接测序法检出突变。结果 74例患者中有69例查到了FⅨ基因58种突变。分析比较这69例患者FⅨ基因突变类型的分布特征与美国白种人无显著性。中国不同地区之间差异也无显著性。结论 中国人血友病B的FⅨ基因突变类型非常分散,呈高度异质性。与美国白种人之间相比差异无显著性。     

改良切开挂线术治疗肛旁脓肿97例临床分析

1对象和方法 1．1对象 1992／2004有完整记载的病例选出男性患者143例,年龄19～79岁,其中坐骨直肠窝脓肿125例,骨盆直肠窝脓肿18例．对其中41例坐骨直肠窝脓肿和5例骨盆直肠窝脓肿采用低切高挂术式,对84例坐骨直肠窝脓肿和13例骨盆直肠窝脓肿采用了我们自己设计的改良切开挂线术式．     

高血压脑出血术后患者肢体功能障碍的康复干预

1 对象和方法 1.1 对象唐都医院神经外科在2003-01/2004-01间收治存活的高血压脑出血患者(不包括既往有脑卒中史,有合并伤及严重认知功能障碍及智力障碍者)56例,随机分为早期康复组28(男16,女12)例,年龄43～72岁,平均(54.16±13.26)岁,左侧肢体偏瘫13例,右侧肢体偏瘫15例;常规治疗组28(男15,女13)例,年龄(45～74)岁,平均(56.73±13.76)岁,左侧肢体偏瘫12例,右侧肢体偏瘫16例.     

LUPUS NEPHRITIS-A CRITICAL ANALYSIS OF 17 PATIENTS

Over a 3 year period from June 94 to June 97, out of 28 patients of systemic lupus, 17 were diagnosed as renal lupus. Demographic data showed 12 females and 5 males, mean age being 32.2 years (range 12 to 54 years). Mean time gap between presentation and definitive diagnosis was 32.4 days (7 days to 5 years). 2 patients (11.76%) presented renal lupus, one (5.88%) with acute interstitial lung disease and the remaining had the usual systemic manifestations of lupus. Anti dsDNA antibodies were positive in all patients while ANA was negative in 3 cases. Renal involvement consisted of rapidly progressive glomerulonephritis in 2 patients (11.76%), nephrotic syndrome in 4 (23.52%) and non nephrotic range proteinuria in 11 (64.70%) patients. Mean serum creatinine at presentation was 2.4mg/dl (0.8mg/dl to 8.9 mg/dl). Three patients were dialysis dependent. Renal histology on light microscopy comprised of class II lesions in one (5.88%), class III in 4 (23.52%), class IV in 11 (64.70%-including one with crescents) and class V in one (5.88%) patient. All patients with advanced class III/IV lesions were treated with corticosteroids and cyclophosphamide pulses. Except one patient who died of pyopericardium all others improved and their serum creatinine stabilised around 2.3 mg/dl (0.8 to 4.6 mg/dl). The study highlights the importance of early diagnosis and aggressive management in this potentially treatable disease.KEY WORDS: Lupus nephritis, Pulse cyclophosphamide