睾丸表皮样囊肿的诊断与治疗（1例报告并文献复习）

目的探讨睾丸表皮样囊肿的临床特点及诊治方案。方法对1例睾丸表皮样囊肿的临床资料进行分析,结合文献复习讨论。结果主要临床表现为阴囊左侧坠胀、疼痛,睾丸触摸到类圆形肿物,双侧腹股沟未触及肿大淋巴结。B超、CT、磁共振均提示睾丸恶性肿瘤可能。行睾丸肿物穿刺活检及切除术后切片病理检查诊断为表皮样囊肿。随访半年无不适。结论睾丸表皮样囊肿是少见的睾丸良性肿瘤,B超、CT、磁共振检查对诊断本病有筛查作用,但主要依靠术前穿刺病理检查确诊,手术切除肿瘤后患者预后好。     

MRI误诊睾丸表皮样囊肿一例并文献复习

<正>95%睾丸内肿瘤是恶性肿块,其中90%～95%是生殖细胞肿瘤,所以通常采用根治性睾丸切除术进行治疗^[1]。如果在术前可预测到良性病变的存在,可以很大比例选择相对保守手术方式,保留睾丸功能。睾丸表皮样囊肿是一种罕见的良性肿瘤,占睾丸内肿瘤的1%^[1-2]。笔者报道1例临床上碰到罕见的术前磁共振影像(MRI)误诊睾丸表皮样囊肿案例,查阅相关文献,对睾丸表皮样囊肿的流行病学、术前辅助检查、手术方式选择及本案例误诊原因等方面进行报道,     

睾丸表皮样囊肿的临床病理分析

目的:提高对睾丸表皮样囊肿诊断及鉴别诊断的认识。方法:收集1例睾丸表皮样囊肿病例,观察和分析其临床和病理组织学特点。结果:术后随访1a,无肿瘤复发及转移。结论:睾丸表皮样囊肿是少见的睾丸良性肿瘤,病史、体检及病理检查对本病的诊断有较大意义,主张采用保存患侧睾丸的肿瘤剜除术。     

睾丸表皮样囊肿诊治分析(附8例报告)

目的 探讨睾丸表皮样囊肿的临床特点与诊治方法 .方法 回顾性分析收治的8例睾丸表皮样囊肿的临床资料.结果 术中取睾丸囊肿及周围组织送快速病理检查,其中7例采用肿瘤摘除术,1例采用睾丸切除术.术后随访10个月～10年,无肿瘤复发及转移.结论 睾丸表皮样囊肿是少见的睾丸良性肿瘤,病史、体检及彩超检查对该病的诊断有较大意义,结合术中快速病理检查,主张采用保存患侧睾丸的肿瘤摘除术.     

睾丸表皮样囊肿临床病理分析

目的提高对睾丸表皮样囊肿诊断及鉴别诊断的认识。方法回顾性分析14例睾丸表皮样囊肿患者的临床和病理组织学特点。结果术后均随访1年,无肿瘤复发及转移。结论睾丸表皮样囊肿是少见的睾丸良性肿瘤,巨检肿瘤的全部取材及蜡块的连续性切片对于诊断及鉴别诊断是非常重要的,主张采用保存患侧睾丸的肿瘤剜除术。     

高频超声诊断睾丸表皮样囊肿的价值

<正>睾丸肿瘤绝大部分为恶性,须行根治性睾丸切除治疗。而睾丸表皮样囊肿是少见的睾丸良性肿瘤,仅需单纯性肿块切除治疗。因此,术前正确诊断对临床治疗方式具有重要指导价值。本文回顾性分析11例经术后病理证实的睾丸表皮样囊肿的超声表现,总结其声像图特征,以期提高超声诊断正确率。1 资料与方法1.1 一般资料回顾性收集2017年6月—2021年6月本院收治的11例经病理证实的睾丸表皮样囊肿患者临床资料,术前均行高频超声检查,     

二维灰阶超声联合超声造影对睾丸表皮样囊肿的诊断价值

探讨二维灰阶超声联合超声造影(CEUS)对睾丸表皮样囊肿的诊断价值。方法 选择2009年7月至2015年12月空军军医大学第一附属医院收治的经手术组织病理证实为睾丸表皮样囊肿的47例患者,回顾性分析患者检查的声像图资料,分析超声术前诊断睾丸表皮样囊肿的准确度。结果 二维超声术前诊断睾丸表皮样囊肿准确度为85.71%(42/49),二维灰阶联合CEUS诊断准确度为93.88%(46/49)。结论 二维灰阶联合CEUS对睾丸表皮样囊肿诊断价值较高。     

睾丸良性病变的MRI诊断

目的探讨睾丸良性病变MRI的表现及诊断价值。方法回顾性分析12例经病理证实的睾丸良性病变患者的MRI平扫及增强扫描的影像资料。结果 12例患者中,良性畸胎瘤2例,表皮样囊肿2例,leydig细胞瘤3例,肉芽肿性炎症3例,结核2例。MRI对睾丸病变定位准确,大多数病变具有一定特征性,良性畸胎瘤可含有脂肪组织或钙化灶,表皮样囊肿有包膜存在,炎症和结核鉴别主要依靠阴囊隔是否有侵犯,leydig细胞瘤无明显特征,容易误诊。结论运用MRI仔细观察睾丸良性病变的形态特征、信号、强化程度及周围情况,有利于病变的定位,有助于病变的诊断与鉴别诊断。     

睾丸表皮样囊肿的超声诊断价值

目的 探讨睾丸表皮样囊肿的超声表现及其与病理的关系.方法 回顾性分析2005年1月-2014年4月在本院行超声检查诊断为睾丸表皮样囊肿的25例病例的声像图资料,诊断结果与病理结果进行对照分析.结果 25例病灶均边界清晰,内无血流信号.12例病灶内部呈“洋葱皮”样或“漩涡”状改变;9例病灶周边有环状或蛋壳样强回声,其中1例病灶为囊实性结节,以实性为主,周边伴蛋壳样钙化;3例病灶同时具有内部“洋葱皮”样或“漩涡”状改变和周边强回声;4例病灶为不均质低回声结节,其内可见多发小片状液化区及点状强回声.超声诊断正确提示,睾丸表皮样囊肿23例,其余2例被误诊为睾丸恶性肿瘤,超声诊断符合率为92％（23/25）.结论 多数睾丸表皮样囊肿的超声表现具有特征性,而对于特征不典型者通过回顾性分析可以发现与其他睾丸肿瘤特别是睾丸恶性肿瘤的不同之处,对于指导临床诊治具有重要的意义.     

睾丸表皮样囊肿（附2例报告并国内20例文献分析）

睾丸表皮样囊肿是一种罕见的睾丸良性病变．约占睾丸肿瘤的1％。虽然尚有不同观点，但多数学者已将其归入生殖细胞肿瘤。通过分析国内至今共20例睾丸表皮样囊肿报告(包括本组2例)并复习国外文献，对其临床和病理特征进行讨论。本病术前常无法确诊，B超及血β-HCG、AFP等检查可有所帮助。单纯睾丸表皮样囊肿可仅行囊肿摘陈术，预后满意。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.