Objective To elucidate the clinical characteristics of patients with empty sella (ES) and to improve the realization of this disease. Methods The clinical data of 44 patients with ES were collected from April 1988 to February 2005 and were retrospectively analyzed. Results (1) The patients, including 13 males and 31 females, aged (53±17) years (23-84). The median duration of the disease was 36 months (5-480). (2) The primary ES (93.2%) was more frequent than the secondary ES (6.8%). Among the patients, 19 cases (43.2%) with hypertension and 17 cases (38.6%) with cerebral infarction were found. Twenty-two female cases (71.0%) were multiparous. (3) The symptoms and clinical pictures included obesity (54.5%), dizziness (43.2%), headache (38.6%), impaired eyesight (20.5%) and hypopituitarism crisis (4.5%). (4) Secondary hypothyroidism occurred in 8 cases (22.9%), secondary hypogonadism in 5 cases (14.3%),secondary hypoadrenalism in 3 cases (8.6%) and hyperprolactinemia in 2 cases (5.7%). (5) The diagnosis depended on CT and MRI. The positive rate of pituitary MRI scan was 100%. Conclusions Long-term follow-up for ES cases is necessary. The patients with hypoadenia need to be treated as soon as possible to prevent the hypopituitarism crisis, which seems not to be infrequent and neads paying particular attention.

BACKGROUND:Bone marrow mesenchymal stem celltransplantation has been confirmed to have excellent effect on the treatment of diabetic foot.
OBJECTIVE:To assess the therapeutic effect of bone marrow mesenchymal stem celltransplantation on diabetic foot ulcers and the expression of vascular endothelial growth factor.
METHODS:Literatures concerning the effect of bone marrow mesenchymal stem celltransplantation on foot diabetic and expression of vascular endothelial stem cells were retrieved. Articles that met the criteria were analyzed in depth. Here, we analyzed the experimental research and clinical application of bone marrow mesenchymal stem cells in the treatment of diabetic foot. In experimental studies, rat models of diabetic foot ulcers were established and subjected to bone marrow mesenchymal stem celltransplantation to observe wound healing of ulcers and analyze the expression of vascular endothelial growth factor. In clinical research, the fol ow-up was conducted in diabetic foot patients undergoing bone marrow mesenchymal stem celltransplantation to observe the wound healing of ulcers and adverse reactions.
RESULTS AND CONCLUSION: Experimental studies have shown that bone marrow mesenchymal stem celltransplantation is better than conventional treatment in the treatment of diabetic foot ulcers, but the healing of diabetic foot ulcers is stil slower than that of normal ulcers. After celltransplantation, the expression of vascular endothelial stem cells is elevated but stil lower than that in the normal ulcer controls. Clinical studies have shown that for patients with diabetic foot ulcers, the ulcer wound can be healed after bone marrow mesenchymal stem celltransplantation, as wel as there are no cardiovascular and cerebrovascular diseases, liver and kidney damage and changes in bleeding and coagulation time.

Carbonic anhydrases(CA)is a zinc-enzyme family。They are involved in multiple aspects of systemic and cellular acid-base balance.This review is a general introduction to the disposition,molecular constitution,biological function and physiological function of CA.

Objective: To explore the clinical features of hypokalemic periodic paralysis, and compare clinical features of primary group with those of thyrotoxicosis secondary group. Methods: Clinical data of 44 patients with hypokalemic periodic paralysis in Peking University First Hospital from 1996 December to 2008 December were retrospectively analyzed. Results: There were 22 patients in primary group, and 22 in thyrotoxicosis group. Identical clinical features of both the groups; (1 ) It had a predilection in young men. (2)Main symptoms were limb movement disorder and fatigue, and paralysis recurrent attacked in most patients. (3) 40. 9% to 68. 2% patients had obvious incentives, and the common ones were a heavy meal, sweet drinks, or strenuous'exercise. (4) Serum potassium levels of the two groups were obviously lower than the normal range. (5) In 20% patients of primary group and 25% patients of thyrotoxicosis secondary group, CK levels were higher than normal, while LDH and HBDH levels were normal.(6) The doses of potassium replishment were not correlated to serum potassium levels at the onset. Different clinical features of the two groups; (1) Patients of thyrotoxicosis group had hypermetabolism symptoms and thyroid dysfunction. Patients of primary group had no hypermetabolism symptoms, and all of them were euthyroid. (2) Serum potassium levels of thyrotoxicosis secondary group were lower than those of primary group significantly [(2.25±.67) vs (2.78±.49) mmol/L, P=0;007]. (3) Hyperkalemia is easier than primary group to rebound in thyrotoxicosis secondary group, after replenishment of potassium. Conclusion: Hypokalemic periodic paralysis has its clinical features, and patients with early diagnosis and replenishment of potassium in time have good prognosis. The doses of potassium replenishment are not determined by serum potassium levels at the onset. Hyperkalemia is easier to rebound in thyrotoxicosis secondary group after replenishment of potassium, serum potassium levels should be monitored closely, and hyperthyrosis radically cured.

SUMMARY Hyperparathyroidism is the clinical syndrome that results from elevated circulating parathyroid hormones,leading to multiple systems manifestations,and is divided into three kinds: primary, secondary and ternary.This patient’s main chief complaint was intermittent melena for 3 days,with the diagnosis of upper gastrointestinal hemorrhage according to endoscopy. Hypercalcemia, hypophosphatemia and high level of circulating parathyroid hormone and chronic renal failure were also found during hospitalization. Furthermore, MIBI showed a parathyroid adenoma located near the isthmus in the lower part of the left lobe. The patient had undergone nephrectomy because of kidney carcinoma 2 years ago. Primary hyperparathyroidism usually has the common gastrointestinal syndrome , but upper gastrointestinal hemorrhage reported as the chief complaint is rare and we had never seen similar reports before.

Objective To explore the value on the treatment of severe acute pancreatitis (SAP) by hemofiltration combined with Dan Sen and catheterizing drainage through laparoscope. Methods Thirty patients of SAP were divided into two groups. On the basis of routine treatment(supportive treatment,suppressing excrine of pancreas stilamin,trypsin inhibitor and antibiotics),hemofiltration,catheterizing drainage,stilamin and Dan Sen were added in group A,while only routine treatment were administered in group B. TNF,IL-6,IL-8,score of Balthazar CT and score of APACHEⅡ were studied in both groups. Results The value of TNF,IL-6,IL-8,score of Balthazar CT and score of APACHEⅡ in group A were significantly lower than those in group B(P

Pregnant women with subacute thyroiditis (SAT) are rare.One case was reported and the clinical features and management principles of SAT during pregnancy were reviewed.In pregnant women with SAT,the illness is usually not serious.If subclinical or clinical hypothyroidism develops,L-T4 must be given and thyroid function be monitored routinely,and the medication be adjusted carefully to ensure the maternal-fetal safety.

Objective To explore a new type community nursing mode which can improve the life quality of community elderly population with depression tendency.Methods In the chosen community of Jilin City,we used Geriatric Depression Scale (GDS) to identify the elderly population with depression tendency.78 elderly people with depression tendency who met the conditions of study were assigned to the intervention group and the control group with 39 people in each group randomly.8-week group-intervention was given to the intervention group,and no intervention was given to the control group.For the intervention group,the total intervention time was 8 weeks,once a week for continuous 8 times together and intervention time was 90 minutes for each time.The Geriatric Depression Scale (GDS) and the world health organization quality of life (WHOQOL-BREF) were used to measure the quality of life of the two groups.Results After intervention,the total scores of the intervention group were significantly lower than those of the control group,the difference was statistically significant.Average scores of each dimension in the life quality of the intervention group were obviously higher than those of the control group.Conclusions Group intervention mode for the community elderly population with depression tendency was feasible,effective,and reasonable.It can be applied to mental health care of community elderly people,and can also provides basis for early discovery and early intervention of the community elderly people with depression.

Objective To explore the clinical features of adrenocortical oncocytoma for better understanding. Methods A total of 586 patients with adrenal cortical adenoma were retrospectively analyzed in our hospital from January 1993 to November 2009, in which 18 were diagnosed as adrenal cortical oncocytoma pathologically, with 7 male and 11 female, aged ( 45.5 ± 15.9 ) years, and the disease course of( 13.3 ± 13.1 )months. Results 6 patients suffered from Cushing's syndrome, 2 primary hyperaldosteronism, 1 had clinical features of both Cushing's syndrome and primary hyperaldosteronism, and 9 were nonfunctional. 4 cases were misdiagnosed as pheochromocytoma preoperatively. All 18 patients were diagnosed by B-mode ultrasound and operation ( 13 by laparoscopy, 5 by laparotomy). 11 tumors were located in the left adrenal while 7 in the right, with the average tumor size of 5.6 cm in diameter. Histopathologically, 1 was oncocytic adrenocortical carcinoma, while 17 were adrenocortical oncocytoma, in which 5 were potentially malignant and 12 were benign. 11 patients were followed up for 20.5±20.1 months. 2 patients were dead, and 9 were alive with tumor recurrence in 1 case.ConclusionsAdrenocortical oncocytoma is a pathological diagnosis and the clinical manifestations are various. The tumors are usually large in size, and can easily be found by ultrasound, but may be wrongly diagnosed as pheochromocytoma.Being different from previous reports, the majority of these patients present with endocrine dysfunction. Most of these cases are benign, but malignant potential is obvious. Therefore,follow-up is very important.

Diabetes insipidus ( DI) could lead to urinary tract dilatation, even renal dysfunction. This study compared clinical features of DI with or without urinary tract dilatation. The results showed that the former had earlier onset age, more male patients, longer duration, and higher serum creatinine, as well as lower urine osmotic pressure and urine specific gravity after injection of vasopressin. But only disease duration was the independent risk factor (OR=1. 248). More nephrogenic DI and more hereditary DI were with urinary tract dilatation compared with central DI or acquired DI.