IgG4相关性疾病(IgG4-related disease ,IgG4-RD)是一组以血清IgG4升高、组织内IgG4阳性浆细胞浸润及纤维化病变为特征的多系统性疾病.IgG4-RD可累及几乎所有器官,以泪腺、唾液腺、胰腺、肾脏、淋巴结、主动脉和腹膜后最多见.累及肾脏时称为 IgG4 相关性肾病(IgG4-related kidney disease ,IgG4-RKD ) ,主要表现为肾小管间质性肾炎(IgG4-TIN ) ,累及肾小球时以膜性肾病(IgG4-MGN)多见[1] ,其他肾脏损害包括肾小球性病变(Ig A 肾病、系膜增生性病变、膜增生样病变、毛细血管内增生性病变等)、肾脏炎性假瘤、慢性硬化性肾盂炎、肾动脉炎等病变[2 ].

OBJECTIVES:Interstitial lung disease (ILD) is an extramuscular manifestation that results in increased morbidity and mortality from polymyositis (PM) and dermatomyositis (DM). The aim of this study was to systematically evaluate risk factors associated with the development of ILD in PM/DM. METHODS:Observational studies were identified from searching PubMed, Medline, Embase, and the Cochrane Library. Pooled odds ratios (ORs) or standardized mean differences (SMDs) and corresponding 95% confidence intervals (CIs) were obtained for the relationships between risk factors and ILD in PM/DM using either fixed- or random-effects models, whichever were appropriate. Heterogeneity tests, sensitivity analyses, and publication bias assessments were also performed. RESULTS:Twenty-three studies were selected for a meta-analysis that included 834 patients and 1245 control subjects. Risk factors that may have increased the risk of developing ILD in PM/DM patients included older age at diagnosis (SMD, 0.35; 95% CI, 0.18-0.52; P < 0.0001), arthritis/arthralgia (OR, 3.17; 95% CI, 1.99-5.04; P < 0.00001), fever (OR, 2.31; 95% CI, 1.42-3.76; P = 0.0007), presence of anti-Jo-1 antibodies (OR, 3.34; 95% CI, 2.16-5.16; P < 0.00001), elevated erythrocyte sedimentation rate (ESR; SMD, 0.48; 95% CI, 0.32-0.64; P < 0.00001), presence of anti-MDA5 antibodies (OR, 18.26; 95% CI, 9.66-34.51; P < 0.00001), and elevated C-reactive protein level (CRP; OR, 3.50; 95% CI, 1.48-8.28; P = 0.004). Meanwhile, malignancy (OR, 0.36; 95% CI, 0.18-0.72; P = 0.004) reduced the risk of developing ILD in PM/DM patients. CONCLUSION:Our meta-analysis results suggest that the association between PM/DM and ILD may be due to such risk factors as older age at diagnosis, arthritis/arthralgia, fever, presence of anti-Jo-1 antibodies, elevated ESR, presence of anti-MDA5 antibodies, and elevated CRP level, while malignancy was associated with a reduced risk of developing ILD. Thus, these variables may be used to guide screening processes for ILD in patients with PM/DM.

目的探讨集体功能操对老年偏瘫患者的康复作用。方法2006年5月—2008年4月,我们对59例脑梗死伴有偏瘫患者进行集体康复操功能锻炼。每周3次,将患者集中在一起,用自编的8节功能操进行康复锻炼,每次约15 min。以改良巴氏指数(MBI)评定表和科室自定的康复功能评定表(关节活动度、协调性和配合程度等)为评价指标,于康复功能锻炼早期评定1次,每次锻炼时记录动态情况,然后在康复功能锻炼中期、后期再评定1次。结果中期、后期患者MBI和康复功能测定较早期、中期有明显改善(P<0.05),差异具有统计学意义。结论集体功能康复操可以减轻患者的原发功能障碍,减少废用性综合征的发生,最大程度地恢复患者的生活活动能力,提高患者的生活质量。

类天疱疮分瘢痕性类天疱疮和大疱性类天疱疮,是自身免疫性疾病.好发于老年人,年龄在60岁以上,一般无明显前驱症状,皮疹出现前也很少发生黏膜损害[1].

如同麻风、精神病、艾滋病等疾病类似,性传播疾病(性病)由于具有一系列不被社会所期望的特征而被冠以坏名声,即被贴上"污名"的社会标签,并可导致针对患者的"歧视"现象出现.虽然社会公众的负面反应有利于从道德角度抑制疫情发展,但却可能会影响患者的正常就医行为,并非总是有利于性病防治工作.尽管此问题已引起医学界和社会学家的关注,但目前为止国内外在此领域的研究报道并不多[1,2].为此,本研究以上海某社区居民(居民)为研究对象,通过对其性病相关污名与歧视现状进行专题调研,为今后相关研究和制订策略提供一些理论依据.

Objective:To observe the clinical efficacy and safety of 0.1% monetasone furoate lotion in the topical treatment of neurodermatitis and eczema. Methods: A randomized double-blind double-simulation parallel controlled clinical trial was conducted. 0. 1% monetasone furoate cream (trade name:Alosonne) was in control. Patients used the cream firstly then the lotion once daily for 4 weeks. Symptom/sign scores were evaluated at the beginning of the treatment and at the 1st.2nd,4th week after the initiation of the treatment. Results: 133 patients with neurodermatitis and 141 patients with eczema were enrolled. There were 137 patients in the treatment group and 138 patients in the control group respectively. All symptom/sign scores and total scores were significantly decreased 1,2 and 4 weeks after the treatment. No statistically significant difference was observed between the two groups. The cure rate and improvement rate in neurodermatitis patients were 59. 09% and 98. 48% in the test group; 71. 21 % and 98. 48% in the control group; respectively. While the cure rate and improvement rate in eczema patients were 49. 30% and 98. 59% ; 58. 57% and 100% in the control group; respectively. No statistically significant difference in efficacy was observed between the two groups. The side effect rate in the test group was 3. 6% ,2. 9% in the control group; respectively. No statistically significant difference in side effect was observed between the two groups. Conclusion:These results suggest that 0. 1 % monetasone furoate lotion is an effective and safe drug in the treatment of neurodermatitis and eczema.

目的:探讨激光治疗后继用5%咪喹莫特乳膏8周减少尖锐湿疣复发的疗效和安全性.方法:对64例尖锐湿疣患者进行前瞻性研究,其中36例仅进行激光治疗(激光治疗组),而另外28例在激光创面完全愈合后再外用5%咪喹莫特乳膏8周(联合治疗组).观察患者在4周、8周和12周时的复发率及不良反应.结果:激光治疗组在4周、8周和12周时的复发率分别为25.0%、13.3%和3.7%,而联合治疗组相应的复发率分别为7.4%、0%和0%.5%咪喹莫特乳膏的局部不良反应发生率为79.2%,主要表现为用药局部红斑(58.3%)、瘙痒(41.7%)、水肿(37.5%)、灼热(33.3%)、疼痛(29.2%)和糜烂(25.0%),其局部不良反应容易耐受而且暂停用药后可迅速痊愈,无系统性不良反应发生.结论:激光治疗后继用5%咪喹莫特乳膏8周,可能是一种安全而且可降低尖锐湿疣复发率的治疗方法.