Small renal oncocytoma with central cystic degeneration

A case of a small renal oncocytoma with central cystic degeneration, 15 mm in diameter, is reported. Contrast-enhanced computed tomography showed the tumor contained a central hypoattenuating region and had an irregular, heterogeneously enhanced wall. Magnetic resonance images showed a well-circumscribed lesion and the T(1)-weighted image indicated medium signal intensity, whereas the T(2)-weighted image indicated slight hypointensity. Both T(1)- and T(2)-weighted images showed central hyperintensity. Our preoperative diagnosis was renal cell carcinoma originating in a renal cyst wall or cystic renal cell carcinoma. Nephrectomy was performed because frozen-section examination did not completely rule out malignancy. The final pathological diagnosis of the entire surgical specimen was renal oncocytoma with cystic degeneration. To our knowledge, this is the 14th case of renal oncocytoma with central cystic degeneration reported in the published works. We discuss herein the variant forms of oncocytoma and difficulties with their preoperative diagnosis, especially when the tumor is small.     

高位复杂性肛瘘38例的临床疗效观察

目的：探讨高位复杂性肛瘘的治疗方法,为今后制定治疗方案提供参考。方法：采用一次性双挂线治疗高位复杂性肛瘘38例。结果：本组38例均一次治愈,治愈率为100%,未发生肛门失禁、移位、瘢痕狭窄等后遗症。结论：一次性双挂线不失为治疗高位复杂性肛瘘的理想方法。     

葡萄膜炎并发白内障手术适应证及手术方法探讨

目的 探讨葡萄膜炎并发白内障的手术适应证及手术方法。方法 对光定位准确，色觉正常，角膜无明显浑浊，眼压正常，无视网膜脱离的并发性白内障27例(27眼)，进行小切口白内障囊外摘出术。术中以不同方法，对炎性机化膜进行清除处理。结果 27例通过手术治疗，视力均得到提高，达到复明效果。结论 葡萄膜炎并发白内障在选好适应证的情况下以适当的方法进行手术，效果是可靠的，对此类患者不应放弃治疗。     

玻璃体切除眼内注硅油术治疗复杂性视网膜脱离

目的　探讨玻璃体切除眼内注硅油术治疗复杂性视网膜脱离的临床效果。方法　对 11例 (11眼 )伴有玻璃体积血、巩膜破裂、严重增殖牵引等的视网膜脱离患者进行玻璃体切除术 ,采用三通道睫状体平坦部切口切除玻璃体、剪断牵引、剥膜、眼内光凝等 ,最后眼内注入硅油。术后随访观察。结果　 11眼中 9眼获得解剖复位 ,占80 %。 2眼出现并发症 ,取出硅油 ,视力及网膜无明显变化。结论　玻璃体切除眼内注硅油术治疗复杂性视网膜脱离安全可靠 ,预后较好。     

Emergency treatment of complicated colorectal cancer in the elderly. Should the surgical procedure be influenced by the factor ‘age’?

KESISOGLOU I., PLIAKOS I., SAPALIDIS K., DELIGIANNIDIS N. & PAPAVRAMIDIS S. (2009) European Journal of Cancer Care
Emergency treatment of complicated colorectal cancer in the elderly. Should the surgical procedure be influenced by the factor ‘age’? The complication rate in patients affected by colorectal cancer (CRC) is high and the prognosis especially in the elderly patients is poor. The aim of this retrospective study is to compare the complicated CRC outcome between elderly patients and a group of patients younger than 70 years old, treated at the same time period. Between 1997 and 2007, 24 patients older than 70 years old with CRC (Group A), in an emergency situation, were operated on by the same team of surgeons. During the same time period, 20 patients, aged less than 70 years (Group B), with similar clinical and surgical findings, were operated on. All patients had undergone emergency procedures for occlusion, perforation and haemorrhage. We compared both groups in terms of preoperative health status, morbidity and mortality rates. According to ASA classification, Group A was considered of greater intraoperative danger (P= 0.01). Despite the fact that there was no statistically significant difference between the two groups, patients aged >70 years presented higher morbidity and mortality rates. This fact is probably due to their overall health status. The surgical approach of patients with complicated CRC should not be influenced by the patient's age.     

无创机械通气治疗老年急性左心衰并呼吸衰竭的效果研究

目的探讨应用无创机械通气治疗老年急性左心衰并呼吸衰竭的效果。方法选取急性左心衰肺水肿并呼吸衰竭患者92例,采用随机数表法分为2组。对照组患者行常规治疗,观察组患者在常规治疗的基础上给予无创机械通气治疗。比较2组患者治疗后临床症状改善、动脉血气分压、RR、p H以及临床效果。结果治疗后,观察组患者临床症状改善情况、p(O_2)、p(CO_2)、RR、p H、总有效率显著优于对照组(P0.05)。结论对急性左心衰肺水肿并呼吸衰竭患者给予无创机械通气治疗,能够有效改善患者的心功能。     

65例老年心肌梗死合并心律失常患者早期康复护理干预对其心功能及预后的影响分析

目的分析早期康复护理干预对老年心肌梗死合并心律失常患者心功能及近期预后情况的影响。方法选择本院收治的65例老年心肌梗死合并心律失常患者,将其随机分为对照组(32例)和观察组(33例),对照组患者采用传统心肌梗死康复法对患者实施常规康复护理,观察组患者采用早期康复护理干预。比较2组患者入组前、入组后4周、3个月、6个月后收缩压、Killip分级、心率、左室收缩功能、每博量,比较2组患者入组后4周、3个月、6个月的运动耐力(步行试验、踏车实验),比较2组患者入组后6个月内心律失常率、再梗死率、病死率。结果 2组患者入组前左室射血分数、Killip分级、心率、左室压力上升最大速率、每博量比较差异无统计学意义(P0.05);随着时间的推移,2组患者的左室射血分数、Killip分级、心率、左室压力上升最大速率、每博量均较入组前有显著改善,每一个观察时间点,观察组的左室射血分数、左室压力上升最大速率、每博量、均显著高于对照组,Killip分级、心率均小于对照组,上述指标组间比较差异有统计学意义(P0.05);观察组患者入组后4周、3个月、6个月步行试验完成率、踏车实验完成率均显著高于对照组,观察组患者入组6个月后心律失常率、心急再梗死率及病死率均显著低于对照组,组间比较差异有统计学意义(P0.05)。结论早期康复护理干预可有效改善老年心肌梗死合并心律失常患者的心功能,改善患者预后质量。