Background:Because of the irrational use of antibiotics,the incidence of antibiotic-associated diarrhea such as pseudomembranous colitis(PMC ) is increasing in China.Aims;To analyze the clinical characteristics of PMC for improving its diagnosis and management.Methods;Patients with endoscopy-proved PMC admitted from Jun.2007 to Feb. 2012 at Hunan Provincial People' s Hospital were enrolled and retrospectively analyzed.Results;A total of 22 PMC patients met the inclusion criteria.Of them,18(81.8%) were over 70 years old and 18 coexisted with underlying diseases.All patients experienced diarrhea and some also had other symptoms,such as abdominal pain,fever,bloody stool during the course of antibiotic treatment.Cephalosporins was the most commonly used antibiotics(14 cases),and 20 patients used two or more antibiotics.Twenty-one patients received colonoscopy and showed typical pseudomembrane.Of them,9 were classified as mild disease,7 were moderate disease,and 5 were severe disease endoscopically.When antibiotics were withdrawn,and metronidazole,vancomycin and probiotic preparations were used,21 patients were cured and discharged.Conclusions;PMC mainly occurs in aged people with underlying diseases.The clinical manifestations are nonspecific in early stage.Colonoscopy is the main approach for the diagnosis of PMC.Cessation of antibiotics,as well as full dosage and full course of metronidazole,vancomycin and probiotic preparations are necessary for the treatment of PMC.

目的探讨急性胰腺炎(acute pancreatitis,AP)的病因和发病学特点。方法回顾性分析2003年10月至2009年9月确诊的502例AP患者的临床资料。结果常见的病因依次为胆石症(21.1%)、酗酒(18.1%)、暴饮暴食(12.9%)、胆系感染(8.2%)和高脂血症(9.4%),不明原因占30.3%。在男性患者中酒精因素居首位(28.0%),胆石症次之(15.6%);在女性患者中胆石症居首位(29.0%),酒精因素仅为(3.7%)。结论胆石症、饮酒和暴饮暴食是胰腺炎最常见的三大病因,男性患者以酒精因素居首位,而女性患者则以胆石症居首位,高脂血症因素比例在升高,不明原因者仍有相当比例。

目的探讨高脂血症性胰腺炎的临床特点。方法以胆源性胰腺炎为对照组,研究高脂血症性胰腺炎的发病年龄、临床表现、生化、B超及CT检查的阳性率等。结果高血脂性胰腺炎的发病年龄较早,重症发病率高,甘油三酯、胆固醇增高较明显,合并脂肪肝的发病率较高,血尿淀粉酶、血脂肪酶及(或)B超检查均正常者,CT检查能有效防止漏诊。结论肥胖或高脂血症患者出现腹痛时,注意高脂血症性胰腺炎发病的可能,血脂检查、胰腺CT有助于临床诊断。

目的观察药物性食管炎的临床特点。方法回顾性分析8例药物性食管炎的诊疗资料。结果药物性食管炎在中青年患者中也不少见,病变灶多位于食管中段。结论临床上不能忽视药物性食管炎的诊断。

目的比较上消化道出血青年与老年患者的临床特点。方法住院的上消化道出血老年组82例、青年组53例,对两组性别构成、并发症、诱因、临床表现及出血原因进行比较分析。结果两组上消化道出血均以男性患者为主,青年组92.45%,老年组73.17%;有明显诱因者青年组明显多于老年组;并发症老年组明显多于青年组;呕血老年组49例（73.17%）,消化性溃疡47例（57.32%）;青年组十二指肠球部溃疡32例（60.38%）;老年组胃溃疡和球部溃疡导致上消化道出血均为20例（24.39%）。结论两组上消化道出血患者,在性别构成、并发症、诱因、临床表现及出血原因等方面均有不同的临床特征。

目的:探讨血清-腹水白蛋白梯度(SAAG)在腹水患者中的诊断价值和有效性以及其最适临界值.方法:选取住院的腹水患者66例,均于同日抽取血液和腹水,采用溴甲酚绿比色法,分别测得血和腹水中的白蛋白含量,计算出SAAG,再根据有无门脉高压,将病人分为门脉高压组和非门脉高压组,比较两组间腹水白蛋白和SAAG的差别,并以SAAG的不同临界值,探讨判断门脉高压性腹水的有效性和最适临界值.结果:门脉高压性腹水的白蛋白(3.52±4.09)g/L、SAAG(21.97±6.76)g/L和非门脉高压性腹水的白蛋白(21.91±8.64)g/L、SAAG(8.40±3.69)g/L间差异均存在非常显著性(P<0.001);以SAAG≥12 g/L作为最佳临界值来判断是否为门脉高压性腹水,其诊断符合率、似然比、正确诊断指数均可达最大值.结论:腹水白蛋白含量的多少可作为区别门脉高压性腹水和非门脉高压性腹水的重要参考资料,尤其是SAAG可为临床提供重要的参考依据;以SAAG≥12g/L作为判断门脉高压性腹水的临界值较SAAG≥11 g/L更具有效性.

目的探讨多种肿瘤标志物蛋白芯片检测系统对胰腺癌的诊断价值及意义.方法所有病人均抽取空腹静脉血2ml送检,严格按照蛋白芯片检测仪的使用说明进行检测.结果胰腺癌病人的单项标志物以CA19-9阳性率最高,其次为CA242、CEA和Fer,而NSE、F-PSA、PSA、HGH、CA15-3的阳性率极低,甚至为零;胰腺癌病人的综合阳性率为87.5%,而慢性胰腺炎病人的综合阳性率仅为22.22%,两组比较差异有显著性.结论多肿瘤标志物的检测对胰腺癌的诊断具有重要价值,但检测NSE、F-PSA、PSA、HGH、CA15-3的意义甚微;综合分析几种标志物的检测结果,较任何单一标志物的阳性率更高;推测在高危年龄段人群,常规进行CA19-9、CA242、CEA、Fer检测,将有助于胰腺癌的早期发现.

Objective To investigate the relationship between the p33 ING1b protein expression and differentiated degree in human gastric carcinoma. Methods p33 ING1b protein expression was detected by S-P immunohistochemical method in gastric carcinoma and normal gastric mucous tissues. Results The positive rates of p33 ING1b protein expression were 75% (15/20) in well-differentiated, 55% (11/20) in moderate-differentiated and 15% (3/20) in poor-differentiated gastric carcinoma, respectively. The positive rate of p33 ING1b protein expression in gastric carcinoma was significantly lower than that in normal gastric mucosa (100%, 60/60) (P0.05). The p33 ING1b expression was positively related with differentiated degree of gastric carcinoma (P0.05). Conclusion There was a loss expression of p33 ING1b protein in gastric carcinoma. The loss expression of p33 ING1b protein was related to differentiated degree of gastric carcinoma.

本文对调整肠道菌群,改善肝硬化患者疗效的治疗方法进行探讨。结果显示,调整肠道菌群能使肝硬化病人的肝功能明显改善。

食管静脉破裂出血是肝硬化门脉高压患者致命的并发症.本院消化内科1995 年12月以来对30例肝硬化食管静脉曲张破裂出血患者行内镜下食管静脉结扎术43例次,取得了较为满意的疗效,现报道如下.

大肠癌在我国发生率较高,比较一致的意见认为其发生与肠道息肉有关.有关大肠息肉的分析在我国报道较多,有一定的地区差异.本文就湖南地区825例大肠息肉进行分析,以期了解该地区大肠息肉的发生部位,组织学类型及年龄的分布规律.