子宫内膜增生性病变与子宫内膜癌的超声诊断价值

目的:探讨子宫内膜增生性病变与子宫内膜癌的超声鉴别诊断及内膜癌肌浸程度的估价.方法:采用术前B超、术后大体标本观察测量,对123例子宫内膜病变患者的声像图资料进行分析并与手术后病理结果对照.结果:①子宫内膜病变者子宫三径之和平均值均大于正常值;②58.6%的子宫内膜增生过长病变患者内膜形态以条形、梭形和正常形态回声;35%的Ⅱ期以上子宫内膜癌患者内膜回声以积液为主兼有其它图像类型;③大于50岁患者不同病理类型病变的子宫内膜平均厚度均超过其正常内膜厚度值,但无明显的规律性.小于50岁的患者内膜增厚主要以子宫内膜增生过长病变为主占48%;④通过超声测量子宫内膜厚度判断子宫内膜癌浅肌层和深肌层浸润符合率均为71.4%.结论:超声检查对判断子宫内膜病变病理类型有一定帮助,内膜厚度、内膜形态、回声特点、及内膜与肌层间的关系等,仅提示病变存在的可能性,要鉴别病变的良恶性、肌层浸润深度,须根据上述回声特点进行综合分析.     

高强度超声对犬前列腺组织损伤的实验研究

目的　探讨经尿道高强度超声 (transurethralhighintensityultrasound ,TUHIU)治疗良性前列腺增生症 (benignprostatichyperplasia ,BPH)的有效性和可行性。方法　对犬前列腺进行TUHIU辐照处理 ,辐照后不同时期处死动物以观察其急性、亚急性和慢性期大体及组织病理变化。同时观察辐照前后影像学变化。结果　TUHIU辐照前前列腺部尿道平均最大宽度为 0 66± 0 12 ( x±s)cm ,辐照 3周后前列腺部尿道平均最大宽度为 2 11± 1 0 7cm ,较辐照前显著增宽。辐照后可见靶区内尿道周围腺体发生凝固性坏死 ,3 0～ 60天后坏死组织脱落尿道呈囊腔状。光、电镜下均可见腺上皮及基质细胞发生均匀性凝固性坏死。辐照后经腹B超示前列腺内部出现液性暗区 ,前列腺呈囊性改变。辐照后即刻各犬均出现短暂性尿潴留、尿频、尿线变细 ,1月后恢复正常。结论　TUHIU可破坏前列腺组织 ,明显增加前列腺部尿道宽度。     

实时超声造影在乳腺肿块诊断中的价值

目的:研究实时超声造影在乳腺良恶性肿块诊断中的价值。方法:实时观察48例乳腺肿块内造影剂微泡的分布,分析造影增强特点,并用ACQ分析软件进行时间-强度曲线分析。结果:乳腺恶性肿块的周围可见蟹足样等一些特征性表现;恶性组明显增强时间及达峰时间比良性组早,峰值强度及曲线下面积较良性组高。结论:实时超声造影有助于乳腺良恶性肿块的鉴别及估测预后。     

Breast augmentation with silicone implants: the role of surgical drainage—report on 502 consecutive patients

Breast augmentation is one of the most frequently performed cosmetic surgery procedures worldwide. We report on a series of 502 consecutive cosmetic breast augmentations by a single surgeon, using both the submuscular and submammary approaches. A vacuum drain was placed in the surgical pocket at the end of the procedure. The drain fluid collection was recorded immediately after the surgery and the following day before removal. A tenfold increase in the amount of fluid collection was noted in the drain’s reservoir. Thirteen patients presented with minor wound healing problems at the second postoperative follow-up, which were treated conservatively; two of them had the implant removed and replaced after 2 months. There were only two capsular contractions at 1-year follow-up. We focus our discussion on the drainage in the early postoperative period and conclude that the routine use of a surgical drainage reduces the risk for complications. Based on our findings, we advocate that short-term routine use of a surgical drain is advisable.     

手术治疗伴逼尿肌乏力的前列腺增生症

目的探讨BPH并有逼尿肌乏力(ACD)的病人是否手术等问题,为BPH并有逼尿肌乏力的病人治疗方法的选择提供依据.方法对尿动力学检查确认有ACD的15例BPH进行手术治疗.手术后复查尿流率.对所得数据进行自身配对t检验.结果术前和术后最大尿流率分别为(3.3±3.1)ml/s和(14.88±6.08)ml/s(P＜0.05).结论在前列腺摘除后,BPH伴有逼尿肌乏力的病人也能够产生有效排尿.故对确有膀胱出口梗阻(BOO)存在的BPH病人,即使有逼尿肌收缩乏力,也应积极手术.     

SA、F/TPSA及PSAD在前列腺癌诊断中的作用

目的 :探讨血清前列腺特异抗原 (PSA) ,血清总PSA及游离PSA比值 (F/TPSA)及前列腺特异性抗原密度(PSAD)在前列腺癌诊断中的作用。方法 :对 5 1例前列腺癌患者及 14 5例良性前列腺增生症患者PSA、F/TPSA及PSAD值的差异进行分析、比较。结果 :前列腺癌组血清PSA及PSAD高于良性前列腺增生组 ;而F/TPSA值低于良性前列腺增生组 ,差异均有显著性。结论 :PSA >4ng·ml-1作为筛选前列腺癌的临界值存在一定缺陷 ;当PSA <10ng·ml-1,F/T值有助于鉴别前列腺癌和良性前列腺增生 ;而PSAD对于筛选前列腺活检病例亦有一定价值。     

经尿道电切与气化切割和激光治疗前列腺增生症的疗效比较

目的 :比较经尿道电切前列腺术 (TURP) ,经尿道前列腺气化切除术 (TUVP)及经尿道接触式激光前列腺切除术 (TULP)的治疗效果。方法 :在 30 0 0例前列腺增生症患者中 ,按三种术式各随机抽取 2 0例术前条件具有可比性的患者 ,进行疗效比较。结果 :3种术式患者手术前后前列腺症状评分 (IPSS)、生活质量评分(QOL)、最大尿流率 (MFR)、剩余尿 (PVR)比较均得到显著改善 (P <0 .0 1) ,3组之间相比差异无显著性意义(P >0 .0 5 )。手术时间 :TUVP及TURP组明显短于TULP组 (P <0 .0 1) ,术中失血量及术后置管时间 :TUVP及TULP组明显少于TURP组 (P <0 .0 1)。TURP组术后继发感染、出血、暂时性尿失禁发生率少于TUVP及TULP组。结论 :3种术式治疗效果相同 ;TUVP操作简单、安全 ,对初学者来说尤其适宜 ;TURP仍为治疗BPH的金标准术式     

Bleeding from foveolar hyperplasia developing on a gastrointestinal stromal tumor of the stomach

A 52‐year‐old Japanese woman who presented with gastrointestinal (GI) bleeding underwent a proximal gastrectomy for a gastrointestinal stromal tumor (GIST) with a foveolar hyperplasia at the apex of the tumor, 4.5 cm in size, located in the upper body of the stomach. Although GIST are often asymptomatic and are found only incidentally, clinical symptoms such as bleeding, abdominal pain, or obstruction, occasionally lead to a premorbid diagnosis. When submucosal tumors present GI bleeding, the source of the bleeding usually is an ulceration of the mucosa over the tumor. However, in the present study, it was thought that the bleeding originated from the region of foveolar hyperplasia.     

The thymus in seronegative myasthenia gravis patients

Summary In 5–10% of all patients with typical generalised myasthenia gravis (MG), serum antibody to the acetylcholine receptor (AChR) is undetectable. To determine whether these represent a distinct subgroup, we have compared the thymuses of 14 seronegatives, 70 seropositives and 12 non-myasthenic controls. By quantitative immunohistology on coded sections, the 7 seronegative samples were clearly distinguishable from the controls by the pronounced lymph node-type T-cell areas in the medulla. While these closely resembled those in the seropositive cases, germinal centres were significantly sparser, and total in vitro IgG production was disproportionately low (per B cell) in the 12 cases tested. Furthermore, specific anti-AChR production was never detected in any of these cultures. The data support the view that the medullary T-cell areas are the most consistent abnormalitiy in the MG thymus (though it may not be primary), and they strongly imply that seronegative and seropositive MG are distinct entities.