ABSTRACT
Objective:To explore the clinical characteristics,diagnosis,and treatments of adrenal insufficiency (AI) in the patients with acquired immune deficiency syndrome (AIDS),and to improve the clinician's understanding of the disease and provide evidences for its diagnosis and treatments.Methods:The clinical data of one patient with AIDS and AI were retrospectively analyzed and the diagnosis and treatments were summarized,and the relative literatures were reviewed.Results:The patient was clearly diagnosed as AIDS and AI after relevant examinations.The symptoms such as fatigue,nausea and vomiting of the patient were disappeared,the food intake of the patient was increased,and the electrolyte was normal after some treatments such as hormone replacement therapy (oral prednisone acetate 5.0 mg at 8:00 am.and 2.5 mg at 4:00 pm.) and symptomatic treatments.The patient died of a severe opportunistic infection when followed up for 37 d.Conclusion:The possibility of AI should be taken into account when the patients with AIDS have unexplained symptoms such as anorexia,nausea,weight loss and more characteristic manifestations such as orthostatic hypotension,hyponatremia or hyperkalemia.Early administration of glucocorticoid replacement therapy is feasible and effective.
ABSTRACT
Objective:To explore the clinical characteristics,diagnosis,and treatments of adrenal insufficiency (AI) in the patients with acquired immune deficiency syndrome (AIDS),and to improve the clinician's understanding of the disease and provide evidences for its diagnosis and treatments.Methods:The clinical data of one patient with AIDS and AI were retrospectively analyzed and the diagnosis and treatments were summarized,and the relative literatures were reviewed.Results:The patient was clearly diagnosed as AIDS and AI after relevant examinations.The symptoms such as fatigue,nausea and vomiting of the patient were disappeared,the food intake of the patient was increased,and the electrolyte was normal after some treatments such as hormone replacement therapy (oral prednisone acetate 5.0 mg at 8:00 am.and 2.5 mg at 4:00 pm.) and symptomatic treatments.The patient died of a severe opportunistic infection when followed up for 37 d.Conclusion:The possibility of AI should be taken into account when the patients with AIDS have unexplained symptoms such as anorexia,nausea,weight loss and more characteristic manifestations such as orthostatic hypotension,hyponatremia or hyperkalemia.Early administration of glucocorticoid replacement therapy is feasible and effective.
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Objective To evaluate the effect of initiative bladder function training on uroschesis and urinary tract infections after caesarean section. Methods Toally 200 puerperas with caesarean section and indwelling catheter were divided into observation group and control group, 100 cases in each group. The control group was given passive bladder function training, and the observation group was given initiative bladder function training. The two groups were compared in terms of postoperative infections in the urinary tract, time for first micturition, residual urine volume and micturition effect. Result After intervention, the rate of urinary tract infections in the observation group was lower than that of the control one , the time for and effect of first micturition were shorter and better than those of in the control group, the residual urine volume was shorter (P<0.05). Conclusion The initiative bladder function training by exercising abdominal muscle combined with levator ani muscle exercise can effectively promote the recovery of bladder function and reduce uroschesis and the rate of postoperative urinary tract infections.
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Objective To investigate the clinical characteristics in nonalcoholic steatohepatitis (NASH),to provide the basis for the early clinical diagnosis.Methods 200 cases of non-alcoholic fatty liver disease(NAFLD) were divided into NAFL group(115 cases) and NASH group(85 cases).Age,gender,body mass index,blood pressure,clinical symptoms,accompany illnesses,biochemical and image index in the two groups were analyzed and compared retrospectively.Results Asthenia,accounted for 40％,which was the most common gastrointestinal symptom of NASH group.and abdominal distension,anorexia,nausea and vomiting,liver area pain and liver were all involved.There were no significant differences in mainly gastrointestinal symptoms between patients with NASH and NAFL group(P ＞ 0.05),but no symptoms incidence of the two group were higher (44.7％ vs 49.2％ ％ P ＞ 0.05) ;the incidence of obesity,hyperlipidemia,type 2 diabetes,hypertension in NASH group were significantly different compared with NAFL(45.9％ vs 20％,41.2％ vs 22.3％,28.2％ vs 15.6％ respectively P ＜ 0.05) ; In NASH group,BMI,fasting glucose(FPG),2hPPG,serum ferritin,hyaluronic acid,Ⅳ collageninsulin resistance index (HOWA-IR)increased significantly compared with NAFL[(28.68 ± 0.92)vs (22.21 ± 0.43),(9.63 ± 0.64)mmol/L vs (4.92 ± 0.78)mmol/L,(12.96 ±0.28) mmol/L vs (7.04 ±0.13) mmol/L,(243.56 ±7.95) ng/mL vs (140.03 ± 6.80)ng/mL,(130.26 ±9.i6)ng/mL vs (74.85 ±6.54)ng/mL,(130.56 ±8.16)ng/mL vs (72.68 ±7.24) ng/mL,(5.36±0.45) vs (2.63 ±0.12),respectively P＜0.05)].Conclusion Patients with NASH had no obvious gastroenterology symptoms.Obesity,type 2 diabetes,hypertension are more with NASH,and there may be multiple metabolic disorders.
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Objective To investigate the influence of left heart function in obstructive sleep apnea by CIH, and explore left heart function before and after CPAP. Methods 75 OSA were divided into two groups. Blood pressures of 40 patients were coincident with diagnostic standard of hypertension and 35 patients did not have hypertension. The control group included 30 healthy adults. The blood pressures before and after sleep, left ventricular ejection fraction(LVEF) ,shortening fraction(FS) , E, A and E/A were compared with those of normal control subjects. BP, LVEF and E/A after CPAP were also analyzed. Results Multiple parameters including LVEF[ ( 56.40 ±9.74)% ] , FS[ (33. 80 ±6.16)% ] and E/A (0. 87 ±0.17) , were impaired in OSA patients relative to the control subjects ( P <0. 05 orP <0.01). E/A was significantly decreased in obstructive sleep apnea unallied hypertension than that in normal control subjects. E/A was conspicuously decreased in obstructive sleep apnea patients associated hypertension comparing with that in obstructive sleep apnea unallied hypertension. After CPAP for 6 months, in these obstructive sleep apnea associated hypertension patients, LVEF [(59.70 ±11. 1)%] was increased than that before treatment[ (56. 40 ± 9.74)% ] ( P <0.05), and E/A (1.16 ± 0. 25 ) was higher than that before treatment (0. 87 ±0. 17) ( P <0.01). Conclusion CIH may affect left heart structure and function. These changes were aggravated with hypertension. CPAP treatment had important effects in the treatment of cardiovascular function, and it could improve the life quality.