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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.
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Objective To elaborate the clinical characteristics of adrenal non-Hodgkin's lymphoma and to expand the clinical thinking of adrenal tumors.Methods Subjects with adrenal tumors and nonHodgkin's lymphomas between January.1994 and December.2012 in Peking University First Hospital retrospectively were included and these with adrenal lymphoma patients were analyzed in the present study.Results Among 1100 adrenal tumors and 1 002 non-hodgkin's lymphomas,21 patients (aged 35 to 80 years,mean 56 years) were diagnosed as having adrenal non-Hodgkin's lymphoma with 14 males and 7 females.Among the 21 patients,15 were with pain on the waist and the back,3 with fever,1 had weight loss.Two patients were diagnosed by regular health examination.Only 2 subjects accompanied by superficial lymph node enlargement,while 10 by abdominal cavity lymph node enlargement.Eleven subjects were with extranodal involvement.Bilateral adrenal were involved in 8 patients with 9 on the left and 4 the right.The average diameter of the masses was 7.2 cm.There were no specific features in conventional imaging such as CT and MRI scan.All of the 21 cases were found normal adrenal function by endocrinological examinations.Pathology reviewed that 18 of 21 were diffuse large B cell non-Hodgkin's lymphoma,2 were T cell lymphoma,1 were anaplastic large cell lymphoma.Only 7 of 21 cases were diagnosed with adrenal lymphoma pre-operation.Seventeen patients were followed up by telephone in September 2014,in which 14 died and the average survival time was 5.5 months,2 were tumor-free survival for 4 and 10 months respectively,1 were currently undergoing chemotherapy.Conclusions Adrenal lymphoma is rare with less superficial lymph node,more bilateral adrenal involved with high malignant degree.It progressed quickly with poor prognosis.Clinical and imaging features were not specific,so misdiagnosis was very common.Pathology is the diagnostic gold standard.The most common type was diffuse large B cell type.
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Objective To summarize the clinical characteristics of adrenal tumors combined with renal carcinoma and to extend the clinical understanding of the situation.Methods To analyze the data of 1 100 patients with adrenal tumors hospitalized in Peking University First Hospital from Jan.1994 to Mar.2012 retrospectively,in the series there were 42 combined with renal carcinoma.Results There were 27 males,15 females,aged 29 to 83 years,mean 60.5 years old.In 42 renal carcinomas,there were 29 (69.0％) clear cell carcinomas,5 (11.9 ％) cystic renal carcinomas,2 (4.8％)clear cell with granulosa cell hybrid carcinomas,1 renal lymphoma,1 (2.4％) spindle cell tumor,1 acidophilic cell adenoma,and 1 undifferentiated type of renal cell carcinoma and pathologically not clear in 2 cases (4.8％).Clinical manifestations were not specific.In 42 adrenal tumors,20 situated in the left,and 17 right,and 5 were bilateral.35 cases were considered primary adrenal tumors,in which 3 were diagnosed primary hyperaldosteronism,32 were non-functional tumors.Other 7 were non-functional matastatic carcinomas.25 patients underwent resection of adrenal tumors,and pathology revealed 22 (88.0％) were primary,in which 12 (54.6％) were cortical adenomas,7 (31.9％) hyperplasia,1 (4.5 ％) pheochromocytoma,1 (4.5 ％) ganglioneuroma,1 (4.5 ％)adenoma with hyperplasia;2 (8.0％)metastatic tumors,and 1 (4.0％) non-Hodgkin' s lymphoma.The mean diameter of primary adrenal tumors was 1.9 cm,while that of metastatic carcinoma was 3.84 cm.25 underwent abdominal ultrasonography,40 underwent computed tomography (CT) scan,6 underwent magnetic resonance imaging (MRI) scan,positive rate was 72.0％,97.5％,and 100.0％ respectively.25 patients who underwent surgery were followed up,17 survived for 8 months-6 years,4 died,in which 1 metastatic carcinoma died of intraoperative bleeding,1 died of adrenal lymphoma,2 died because of other disease,4 were lost to follow-up.Conclusions The most common type of renal carcinoma combined with adrenal tumors was clear cell carcinoma,while majority of the adrenal tumors were primary with non-specific clinical manifestations and function.The adrenal tumors might be located in the same or the opposite side of renal carcinoma,also might be bilateral which were more common in metastatic carcinomas and always bigger than primary ones.CT/MRI scans were important in judging the nature of the tumors and pathology was the gold standard.The non-functioning primary adrenal tumors could be safely followed up,and the isolated metastatic carcinoma should be resected.Prognosis depends mainly on that of renal carcinoma.
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To summarize the clinical data of two cases with severe hyponatremia diagnosed as adrenal insuffiency combined with syndrome of inappropriate secret on of antidiuretic hormone(SIADH),and to review related literatures.Case 1 diagnosed as Addison's disease for 27 years and developed severe hyponatremia again but did not response well to sufficient glucocorticoid.Further examination showed SIADH caused by lung cancer and tolvaptan worked well.Case 2 was diagnosed as SIADH caused by lung cancer and responsed well to tolvaptan.However,hyponatremia reoccurred with the decreasing level of ACTH and cortisol during the chemotherapy.It was thought that hyponatremia was caused by drug-related adrenal insuffiency and glucocorticoid replacement therapy achieved good response.Both primary/secondary adrenal insuffiency and SIADH can lead to severe hyponatremia,but it is rare that the two situations exist in one patient and occur in different time.We should consider the possibility of the situations when we make differential diagnosis of refractory hyponatremia,monitoring the curative effects carefully,then correct the diagnosis timely,and reduce missed diagnosis and misdiagnosis.
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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.
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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.
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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.
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ObjectiveTo observe the changes of the levels of serum TNF-α and IL-6 in patients with hypertensive disorders in pregnancy(HDIP),to explore the significance of serum TNF-α and IL-6 in HDIP.MethodsThe levels of serum TNF-α and IL-6 in 30 patients with HDIP( 11 cases with gestational hypertension,11 casses with mild preeclampsia,8 cases with severe preeclampsia) and 18 healthy pregnant women were detected.ResultsThe levels of serum TNF-α in HDIP were( 1.88 ±0.48) μg/L,(2.32 ±0.40) μg/L and(2.35 ± 0.42) μg/L,The levels of serum IL-6 of HDIP were (99.54 ± 31.62) ng/L,( 120.53 ± 26.42)ng/L,( 140.83 ± 22.13 ) ng/L respectively,the serum levels of TNF-α and IL-6 in healthy pregnant women were( 1.63 ± 0.32)μg/L and(95.82 ± 30.65 )ng/L,there was significant difference among them ( all P ＜ 0.05 ).ConclusionThe serum levels of TNF-α and IL-6 in HDIP were higer than those in healthy pregnant women,and vascular endothelium cell injury should play an important role in the pathogenesis and development of HDIP.
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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.
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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.
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objective To evaluate the distribution and significance of IgG subclasses of antithyroglobulin antibody in sera from patients with Hashimoto thyroiditis.Methods Sera from 112 patients with Hashimoto thyroiditis were collected and patients were divided into 3 groups,i.e.hypothyroidism,subclinical hypothyroidism and euthyroidism.Antigen specific ELISA was used to detect the distribution of IgG subclasses of antithyroglobulin antibody.Results The positive rates of IgG subclasses of TgAb were IgG1 90.2%,IgG2 58.0%,IgG3 19.6%and IgG4 87.5%respectively.The mean geometric titers of IgG1 in sera from patients with hypothyroidism and subclinical hypothyroidism were 1:450.8 and 1:245.5 respectively,both being significantly higher than that with euthyroidism(1:8.7,P＜0.01).The mean geometric titers of IgG2 in sera from patients with hypothyroidism and subclinical hypothyroidism were 1:37.3 and 1:3.2 respectively,both being also significantly higher than that with euthyroidism(1:0.2,P＜0.01 and P＜0.05 respectively)and that with hypothyroidism was significantly higher than that with subclinical hypothyroidism(P＜0.05).Conclusion The distribution of IgG subclasses of antithyroglobulin antibody in sera from patients with Hashimoto thyroiditis was predominantly IgG1,IgG2 and IgG4.High titers of IgG1 and IgG2 implicated the possibility of development from subclinical hypothyroidism to overt hypothyroidism.
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Objective To investigate the relation among the results of thyroid fine needle aspiration cytology(FNAC),thyroid ultrasonography(US)and histopathologic diagnosis about the thyroid nodules detected by physical examination,meanwhile to analyze the etiopathogenesis of the nodtries and to evaluate the risk of thyroid cancer and the clinical diagnostic value of FNAC.Methods The data of thyroid FNAC results of the thyrroid nodules detected by physical examination in 271 cases were analyzed and compared with thyroid US and histopathologie diagnosis.Resuit (1)The FNAC results showed that the incidences of malignant and suspected mali-gnant lesions were 1.48%and 5.90%respectively.The rate of benign lesions was 78.60%and that of goiter was 29.15%,Hashimoto's thyroiditis 26.57%and thyroid adenoma 15.13%.Benign lesions were more common than malignant ones.(2)Comparison of the FNAC and US results of the thyroid nodules showed that of 96 cases with single nodule the rates of malignancy and suspected malignancy were 3.12%and 7.29%,but of 137 cases with multiple nodules the rates of the two lesions were 0.73%and 6.57%.In 108 cases with smaller nodules(≤1.5 cm)the rate of malignancy and suspected malignaney found with FNAC were 0.93%and 7.41%,while in 125 cases with greater nodules (＞1.5 cm)the rate of the two lesions were 2.40%and 6.42%.In 99 solid nodules the rates of malignancy and suspected malignancy were 2.02%and 12.12%,while in 85 cystic or mixed nodules the rates of the two lesions were 2.35%and 2.35%.In the above-mentioned three groups,only the suspected malignaney rate in solid nodules was higher than these in cystic or mixed ones with significant difference (P=0.013).(3)As compared with the cytological and histological diagnoses in 24 cases,the diagnostic accuracy of FNAC was 75.00%and the rates of false positive and false negative were 25.00%and 0,respectively.Conclusions The common causes of the thyroid nodules detected in physieal examination are goiter,Hashimoto's thyroiditis and thyroid adenoma.FNAC is a reliable method to define the benign or malignant nature of thyroid nodules with a high diagnostic accuracy.US features of the nodule alone,no matter it is single,solid or of greater size do not sufficiently increase the incidence of thyroid carcinoma.
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Objective To understand the incidence of subclinical thyroid dysfunction in adult population of Beijing.Methods Serum levels of thyroid-stimulating hormone(TSH),T3,T4 and thyroid peroxidase antibody(TPOAb)were measured for 1966 persons living in Beijing by physical examinations in 2002,and 1646 of them(83.72%)were followed-up in 2004.Results Overall incidence of subclinical hypothyroidism and subclinical hyperthyroidism were 1.72 percent and 0.25 percent,respectively.Incidence of subclinical hypothyroidism in females aged ＞40 years was significantly higher than that in those ≤40 years(χ2=10.869,P＜0.01),but no significant difference between those ＞40 and ≤40 years in males was found.Incidence of subclinical hypothyroidism in females was significantly higher than that in males ＞40 years of age(χ2=24.122,P＜0.01),but no significant difference between females and males ≤40 years was found.No significant difference in incidence of subclinical hypothyroidism was noticed between varied age groups and between males and females.Incidence of subclinical hypothyroidism was significantly higher in those with history of subclinical hypothyroidism than that in those without it(χ2= 6.898,P＜0.01).No significant difference in incidence of subclinical hypothyroidism between those with family history of thyroid disease and those without it was found.Incidence of subclinical hypothyroidism was significantly higher in those with positive TPOAb than that in those with negative one(χ2=14.084,P＜0.01),but no significant difference in incidence of subclinical hyperthyroidism between those with positive and negative TPOAb was found.Conclusion Incidence of subclinical hypothyroidism was a little bit higher in population of Beijing area by physical examinations,particularly in females,elder age and positive TPOAb.
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Background Familial hyperaldosteronism type Ⅱ(FH-Ⅱ) is characterized by autosomal dominant inheritance and hyperaldosteronism.Linkage analysis demonstrated chromosome 7q22 most likely harbor the genetic defect.Objective To identify the disease locus in a Chinese pedigree with FH-Ⅱ using genetic linkage analysis.Methods Haplotypes of the FH-Ⅱ pedigree were analyzed using four microsatellite markers(D7S531,D7S2521,D7S511,D7S481) at 7p22 to determine the critical region,and multipoint logarithm of odds(LOD) scores were calculated to assess linkage with FH-Ⅱ.Results Several members(affected members) in the family had hypertension,hypokalemia,hyperaldosteronism,low renin activity.Hypertension and hypokalemia was improved by spironolactone test.Dexamethasone suppression test was performed but without clinical or hyperaldosteronism improvement in three affected members,confirmed FH-Ⅱ family pedigree.The same haplotypes D7S531(ac,n=24)-D7S2521(ac,n=11)-D7S511(ca,n=21)-D7S481(ac,n=16) were shared by all known affected members and one suspicious member,but also by one unaffected member of the family,making it unlikely that this region contains the causative gene mutation.In this FH-Ⅱ family,the LOD scores of the four markers were
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Objective To explore the expression and significance of CD26/DPPⅣand galectin-3 in papillary thyroid carcinoma.Methods Expression of CD26/DPPⅣ or galectin-3 in 68 papillary thyroid carcinomas and 36 thyroid adenomas were determined with EnVision immunohistochemical technique respectively.Results CD26/DPPⅣ and galectin-3 were highly expressed in most of papillary carcinomas but absent or expressed in a low level in most of all thyroid adenomas.With CD26/DPPⅣ as marker to detect papillary carcinoma,the sensitivity,specificity,diagnostic accuracy were 86.8%,97.2% and 90.4%,and with galectin-3 the respective figures were 97.1%,91.7% and 95.2%.There was no statistic significance in intrathyroidal and extrathyroidal invasion,with or without lymph node metastasis,low and poor prognosis groups about positive expression of CD26/DPPⅣ or galectin-3 in papillary carcinomas.Conclusion Both CD26/DPPⅣ and galectin-3 are potential markers of papillary thyroid carcinoma.CD26/DPPⅣ or galectin-3 immunohistochemical staining can be used as a supplement technology for routine pathological diagnosis to differentiate thyroid papillary carcinomas from adenomas,but not accepted as the bio-markers for the invasion,metastasis and prognosis of papillary thyroid carcinomas.
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@#ObjectiveTo apply the Schwann cell neurilemma channel(SCNC) in promoting the regeneration of injuried spinal cord.MethodsSpinal cords of rats after laminectomy at T8/9 were divided in 3 groups randomly: 10 rats were transplanted with SCNC(Group A);10 rats only made models(Group B);10 rats were as normal control group(Group C).All rats received behaviour survey and inclined plane test every week 8 weeks after operation.6 weeks after operation,they were measured with cortical somatosensory evoked potential(CSEP).And 8 weeks after operation,all specimens were studied histologically.ResultsCSEP could be recorded in group A and C,but not in group B.There were marked differenties between group A or C and group B in behavior survey,inclined plane test.Amount of nerve fibers regenerated through the injury gap in group A was significantly larger than that in group B.ConclusionSCNC could facilitate axonal regeneration and promote the repairing of injuried spinal cord.
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Objective To evaluate the treatment of postoperative bile-duct residual stones with rigid cholangioscopy. Methods Three hundred and twenty-seven cases of bile duct residual stones were treated with rigid cholangioscopy. As a route for the rigid cholangioscopy, the T-tube tract (315 cases), the U-tube tract (5 cases) and the jejunostomy tube tract of efferent limb (7 cases) were used. Results Four hundred and eighty-six rigid cholangioscopic sessions were carried out, 1.5 sessions on the average for each patient. Treatment was successful in all but one patient in whom rigid cholangioscopic access to bile duct was difficult since the T-tube tract was too long. The rate of complete removal of the stones was 95.4%. There were no serious complications. Conclusions It′s possible to pass the instrument into the common bile duct and the majority of the intrahepatic bile duct. Many of the problems associated with residual stones can be overcome by this method and good results achieved. This technique seems to be a useful new alternative in patients with difficult retained bile duct stones.
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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
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Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.
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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.