胸腔积液215例病因分析及临床特点

目的分析胸腔积液的病因,为临床诊治提供参考。方法对215例已明确诊断的胸腔积液患者的临床资料进行分析。结果胸腔积液的病因以结核性（42.79%）和癌性（23.72%）为主,其他病因较为少见。结论胸腔积液的病因以结核性和癌性为主,其他病因较为少见,少部分胸腔积液病因不明。     

500例慢性盆腔疼痛患者临床分析

对500例慢性盆腔疼痛患者的临床表现、各项检查结果和病因进行回顾性分析。结果充分寻找病因,根据患者的病因及其年龄等方面对患者进行不同的治疗,明显提高了患者的生存质量。积极明确慢性盆腔痛的病因,采取有针对性的检查和治疗,对改善妇女的身心健康具有重要意义。     

临床医生如何做好病因研究

目前,临床医生开展病因研究的热情逐年高涨。这不仅说明临床医学界越来越注重疾病病因在疾病防治中的作用,更显现出我国临床医生学术研究视野正日趋开阔。但目前临床医学界普遍对病因观和病因研究方法的复杂性认识不足。本文针对临床医生的需求,简要介绍流行病学的病因概念、病因分类及病因研究思路,以帮助医生在进行病因研究前能形成较为完整的顶层设计。     

新生儿和婴儿肝炎综合征的诊断与处理

婴儿肝炎综合征临床上较为常见,病因复杂,但感染尤其是病毒感染为常见的病因.临床表现主要有持续性黄疸、肝或肝脾肿大、肝功异常等症候群.诊断时应尽量明确病因,但仍有不少患儿病因较难确定.婴儿肝炎综合征目前尚无特效治疗,强调对症、营养支持,护肝利胆,积极进行病因治疗.对终末期肝病可考虑肝移植.预后与病因有关.感染性者大多预后良好.     

心包积液39例病因分析

目的 提高对心包积液病因的再认识.方法 对我院收住39例心包积液患者的病因作回顾性分析.结果 常见的病因为心力衰竭性(14例)、结核性(9例)、癌性(6例),少见的病因为类风湿性、甲状腺功能减退性、病毒性心包炎性(各2例),嗜酸粒细胞性、系统性红斑狼疮性、尿毒症性、流行性出血热性心包积液(各1例),初诊全部误诊,死亡9例.结论 提高对常见的及少见心包积液病因的认识,有助于及时诊断并针对病因治疗,从而降低病死率.     

儿童慢性咳嗽的病因频率分析——附101例报告

目的：探讨儿童慢性咳嗽的病因频率分布。方法：对101例慢性咳嗽患儿进行病因调查,并对其中获得明确诊断的病因进行数理分析。结果与结论：101例中,明确诊断82例90例次,其中仅1种病因76例,2种病因4例,3种病因2例,疑似诊断17例（16．8％）,病因未明2例（2．0％）。确诊的82例中,主要病因有气管支气管异物,肺炎,咳嗽变异型哮喘或哮喘,鼻后滴流综合征和上呼吸道感染,其病因频率分别为26％、21％、18％、10％、7％。其中1岁以下患儿的病因以肺炎居多（8例次,占67％）;1～3岁患儿的病因以气管支气管异物居多（15例次,占54％）;大于3岁患儿的病因以咳嗽变异型哮喘或哮喘居多（13例次,占26％）。儿童慢性咳嗽的病因复杂,不同的年龄段患儿的慢性咳嗽病因分布有一定特征性。     

腹水87例临床分析

腹水的病因甚为复杂,最常引起腹水的病因为肝病和门脉循环系统疾病．其次为癌性腹水及结核性腹水．其他包括心功能不全、胰源性腹膜炎及肾功能不全等.对腹水的病因进行分析和诊断一直是临床难题。本次研究分析87例腹水患者的临床资料,对腹水的病因和血清-腹水白蛋白浓度梯度（serum ascites albumin gradient,SAAG）进行了分析,观察SAAG在腹水诊断中的价值,并对其明确病因采取的诊断方法进行总结分析。现报道如下。     

不明原因发热病因变迁图绘出：结核病始终位列病因首位未获明确诊断比例明显上升

不明原因发热（fever unknown origin,FUO）的病因诊断是临床常见难题。北京协和医院感染内科刘晓清、侍效春等对本院6年间997例FUO病因构成进行分析,并比对1985年以来3组研究数据,绘出中国FUO病因26年变迁图,提示结核病仍是中国FUO病因之首。     

体外循环肾损伤机制及目前保护措施

体外循环下心脏外科直视手术术后的肾损伤,病因复杂,病情较重,病死率较高,近年来对肾损伤的病因及机制的研究取得很大的突破,随着从细胞、分子水平进一步的揭示肾损伤的发病病因和机制,将来有望综合治疗手段来阻止肾损伤进程,促进肾保护。本文对近年来国内外有关体外循环术后肾损伤的病因研究及保护进展予以综述。     

老年心力衰竭住院患者的病因状况调查

目的 了解我院1999-2004年老年心力衰竭住院患者的病因构成情况.方法 对病历进行回顾性分析和比较.结果 前三位的基础病因为心肌梗死、高血压、糖尿病,68.2%病例为多病因心衰,并且随年龄比例逐渐增大,多病因组合中,双病因组合最多见的是冠心病和高血压,3种以上病因最多见的组合是冠心病、高血压和糖尿病.结论 老年心力衰竭住院患者的病因主要是心肌梗死、高血压、糖尿病,随年龄老化,多病因心衰比例逐渐增大.临床护理中,应加强该类老年患者规范化、程序化、个性化的健康教育,提高自我保健意识,减少慢性心衰的发生.     

A comparison of substance abuse and violence in the prediction of long-term rehabilitation outcomes after traumatic brain injury

OBJECTIVE: To determine the relative contributions of substance abuse history and violent etiology to the prediction of outcomes for individuals who sustained a traumatic brain injury (TBI) requiring inpatient rehabilitation. DESIGN: Longitudinal study of outcomes 1 year postdischarge from rehabilitation. SETTING: Specialized TBI acute rehabilitation unit. PARTICIPANTS: Three hundred fifty-one individuals consecutively admitted for rehabilitation. INTERVENTIONS: Gathered data from patients' medical records (including etiology of injury, initial Glasgow Coma Scale scores, and FIMtrade mark instrument scores at discharge), demographic details, and history of substance abuse; phone and mail survey data from individuals (Satisfaction with Life Scale [SWLS]; Community Integration Questionnaire [CIQ]). MAIN OUTCOME MEASURES: CIQ and SWLS; relative contributions of injury etiology, demographic and injury-related dependent variables, and substance abuse history to predictive model. RESULTS: Almost 80% of persons with injuries from violence-related causes had a history of substance abuse. Substance abuse was found to contribute to the prediction of life satisfacton and productivity, while violent etiology was not a significant contributor to predictive models. CONCLUSION: Substance abuse history proved to be a strong predictor of long-term outcomes, while violent etiology of injury was less influential. The results of this study emphasize the need to include substance abuse history in all studies of outcomes after TBI, and to increase prevention efforts to limit the effects of such a history.     

老年心房颤动177例回顾性分析

目的探讨老年人阵发性心房颤动(房颤)与慢性房颤的病因及相关因素,了解其防治现状。方法回顾性分析177例资料完整的老年房颤患者的资料,将阵发性房颤和慢性房颤的病因及相关因素进行了比较。结果老年阵发性房颤发生率高于慢性房颤(54.4%∶45.6%);177例老年人房颤的病因及相关因素中,高血压、冠心病、糖尿病、心衰、钙化性瓣膜病在阵发性房颤与慢性房颤之间的发生率均差异有统计学意义(P<0.05);慢性房颤患者左房、左室增大及脑卒中的发生率高于阵发性房颤(P<0.05)。阵发性房颤以转复心律为主,维持窦性心律,慢性房颤以控制心室率为主。结论老年人阵发性房颤的发生率高于慢性房颤。阵发性房颤以复律为主,慢性房颤以控制心室率为主。     

无精子症的病因及治疗进展

无精子症是临床中常见的男性不育症,其病因与治疗均比较复杂。本文对无精子症的病因睾丸前因素、睾丸因素与睾丸后因素及治疗包括药物治疗、手术治疗与辅助生殖技术等作一综述。     

Extracorporeal detoxification of the body and the B system of immunity in acute peritonitis

65 patients with acute peritonitis of various etiology have been examined. It has been established that marked toxemia in the early postoperative period, normal relative B-lymphocyte content, low level of EAC-RFC with moderate to high content of receptors to sheep red blood cells are prognostically unfavourable. The level of intermediate molecular mass polypeptides (IMMP) above 0.4 units and absolute absence of B lymphocytes with high receptor density during one postoperative week seem threatening and are an indication for hemosorption (HS). HS in patients with high toxin content was accompanied by a positive clinical effect related to its non-specific stimulation of qualitative and functional B-lymphocyte properties including their receptor apparatus due to IMMP removal from blood.     

Inflammatory priming predisposes mice to age-related retinal degeneration

Disruption of cellular processes affected by multiple genes and accumulation of numerous insults throughout life dictate the progression of age-related disorders, but their complex etiology is poorly understood. Postmitotic neurons, such as photoreceptor cells in the retina and epithelial cells in the adjacent retinal pigmented epithelium, are especially susceptible to cellular senescence, which contributes to age-related retinal degeneration (ARD). The multigenic and complex etiology of ARD in humans is reflected by the relative paucity of effective compounds for its early prevention and treatment. To understand the genetic differences that drive ARD pathogenesis, we studied A/J mice, which develop ARD more pronounced than that in other inbred mouse models. Although our investigation of consomic strains failed to identify a chromosome associated with the observed retinal deterioration, pathway analysis of RNA-Seq data from young mice prior to retinal pathological changes revealed that increased vulnerability to ARD in A/J mice was due to initially high levels of inflammatory factors and low levels of homeostatic neuroprotective factors. The genetic signatures of an uncompensated preinflammatory state and ARD progression identified here aid in understanding the susceptible genetic loci that underlie pathogenic mechanisms of age-associated disorders, including several human blinding diseases.     

自发性扁桃体出血（附2例临床分析）

目的：讨论自发性扁桃体出血的病因、诊断及治疗。方法：2例自发性扁桃体出血患者，分别行局部缝扎、扁桃体切除＋颈外动脉造影选择性动脉栓塞治疗。结果：2例均治愈，随访2年无复发。结论：自发性扁桃体出血病因不明，目前考虑主要与细菌感染有关，诊断依靠临床表现，治疗方法包括局部烧灼、扁桃体切除、颈外动脉造影选择性动脉栓塞等。     

糖尿病继发阴囊坏疽的诊治

目的：探讨糖尿病继发阴囊坏疽的病因和诊治，提高该病的诊治水平。方法：回顾分析7例糖尿病继发阴囊坏疽并复习相关文献。结果：5例经全身综合治疗和局部彻底的清创后治愈出院。2例因病情延误，死于感染性休克、急性肾功能衰竭、多器官功能衰竭。结论：熟悉该病的病因和演变，早期诊断，及时彻底的切除坏死组织。早期联合应用广谱抗生素，控制血糖，是抢救病人生命的关键。     

Genetic aspects of inflammatory bowel disease

There is ample evidence in the literature that both Crohn's disease and ulcerative colitis are at least partly caused by genetic factors. For the future, it is important to locate markers that can separate patients from healthy individuals. The relative importance of these markers in the etiology can then be investigated by using statistical methods such as segregation analysis.     

结核性腹膜炎致乳糜性腹水1例并文献复习

目的探讨乳糜性腹水的病因、诊断和治疗。方法报告结核性腹膜炎致乳糜性腹水病例1例,结合其临床资料并复习相关文献,探讨乳糜性腹水的病因及诊治方法。结果通过各项诊断方法及时诊断,经内科常规抗痨治疗后,病人病情得到缓解。结论乳糜性腹水应注意及早明确病因,针对病因予规范、有效及系统治疗。     

Prader-Willi syndrome, diabetes mellitus and hypogonadism

Diabetes mellitus is not a diagnostic criterion for Prader-Willi syndrome (PWS), but it is often found in PWS patients. The etiology for diabetes mellitus in PWS may be related to the morbid obesity and consequent insulin resistance, because a decrease of oxytocin neurons and leptin resistance in PWS may cause hyperphagia, inducing obesity. However, treatment with growth hormone (GH) is beneficial for the majority of GH-deficient PWS children, because relative decreased fat mass and increased fat-free mass could prevent obesity and concomitant insulin resistance. Hypogonadism is thought to be due to hypogonadotrophic hypogonadism in a majority of PWS patients. Hypergonadotrophic hypogonadism secondary to cryptorchidism and its treatment is shown in other cases. Low luteinizing hormone and high follicle-stimulating hormone levels in PWS cases in young men with idiopathic oligospermia or in the early stages of puberty is less frequently reported.