前列腺切除术后排尿困难28例临床分析

目的探讨前列腺切除术后排尿困难的原因及防治措施。方法对28例前列腺切除术后排尿困难患者的临床资料进行回顾性分析。结果膀胱颈部狭窄13例,后尿道狭窄5例,前尿道狭窄2例,腺体残留5例,膀胱逼尿肌功能障碍3例。尿道扩张联合开放手术或腔内电切术治愈25例,永久性膀胱造瘘3例。结论膀胱颈部狭窄、尿道狭窄、腺体残留、膀胱逼尿肌功能障碍是术后排尿困难的主要原因,多由医源性因素引起。术前行尿流动力学检查,术中术后操作得当可以避免这些并发症。尿道扩张联合开放手术或腔内电切术是前列腺切除术后排尿困难较为有效的治疗方法。     

经尿道前列腺切除术后排尿困难原因分析及处理

目的探讨经尿道前列腺切除术后再次排尿困难的原因及处理措施。方法回顾分析530例经尿道前列腺切除术后再次排尿困难的30例患者临床资料。结果本组30例术后拔除尿管后出现排尿困难。其中尿道狭窄12例、膀胱逼尿肌功能障碍5例、继发出血5例、再发前列腺癌3例、腺体残留5例。结论尿道狭窄、膀胱逼尿肌功能障碍、继发出血、腺体残留、再发前列腺癌是发生前列腺电切术后排尿困难的主要原因,术前行尿流动力学检查、精细的手术操作、术中仔细止血,可以减少术后排尿困难的发生。     

经尿道前列腺切除术后并发症及护理

良性前列腺增生(BPH)是一种老年人常见疾病,俗称"前列腺肿大".它的发病原因是由于前列腺中叶增生为实质性改变,临床表现主要有尿频、尿急、尿不尽、排尿困难以及尿潴留等[1].良性前列腺增生症多采用手术治疗,经尿道前列腺电切除术(TURP)是一种很有效的治疗BPH的方法,目前已被公认为治疗BPH的金标准.TURP造成的创伤小,可以有效减少病人痛苦,并且手术时间短,术后恢复快,疗效令人满意[2].但由于老年人体质下降等原因,TURP容易出现一些并发症,比如电切综合征、术后继发性出血和膀胱痉挛等.采取合适对策,减少并发症的发生,已经成为人们越来越关注的问题.本研究通过对62例良性前列腺增生患者术后并发症的观察,总结了临床护理对策,现报告如下.     

子宫颈癌术后放疗所致膀胱自发破裂1例

盆腔放射治疗后膀胱的并发症包括出血性膀胱炎、溃疡、膀胱挛缩、尿失禁或瘘[1]。非外伤性膀胱破裂又称为膀胱自发破裂,可有多种原因造成[2]。我们在此报道1例子宫颈癌术后放疗所致的膀胱自发破裂。患者女,65岁,因子宫颈癌术后排尿困难5个月,下腹部疼痛1个月,于2005年2月15日入院。患者5个月前因子宫颈癌于外院行根治性子宫切除术,术前无泌尿系统及神经系统病史,术中未发现膀胱有肿瘤侵犯,术后病理为子宫颈鳞状细胞癌,FIGO分级Ⅱb。术后患者出现排尿困难及尿潴留,经留置导尿管等处理,无明显好转。1个月前于外院行放疗,方法为8 MV-X线全盆…     

前列腺增生术后排尿困难的原因和治疗

目的：研究分析前列腺增生术后排尿困难的原因和治疗措施。方法：对我院2012年7月至2013年9月收治的86例前列腺增生患者进行分析,其中耻骨上经膀胱前列腺摘除术34例,经尿道前列腺电切除术52例,在患者术后发生排尿困难的患者有45例,并对45例患者的排尿困难原因和治疗措施进行回顾性分析研究。结果：通过治疗后,痊愈的患者有43例,2例膀胱造瘘。在2例膀胱造瘘患者中,1例为神经院校膀胱,经过保守治疗无效,另外1例多段尿道狭窄,由于年龄较大,体制较弱,不适合进行大手术,仅进行耻骨上膀胱穿刺造瘘术。结论：前列腺增生术后排尿困难的主要原因有尿道狭窄、前列腺再增生、膀胱功能障碍,正确的术前诊断,术中和术后处理,可以有效的提高手术的质量,同时进行必要的术后随访,有利于减少排尿困难的发生。     

前列腺增生术后排尿困难的原因和治疗

目的:研究分析前列腺增生术后排尿困难的原因和治疗措施。方法:对我院2012年7月至2013年9月收治的86例前列腺增生患者进行分析,其中耻骨上经膀胱前列腺摘除术34例,经尿道前列腺电切除术52例,在患者术后发生排尿困难的患者有45例,并对45例患者的排尿困难原因和治疗措施进行回顾性分析研究。结果:通过治疗后,痊愈的患者有43例,2例膀胱造瘘。在2例膀胱造瘘患者中,1例为神经院校膀胱,经过保守治疗无效,另外1例多段尿道狭窄,由于年龄较大,体制较弱,不适合进行大手术,仅进行耻骨上膀胱穿刺造瘘术。结论:前列腺增生术后排尿困难的主要原因有尿道狭窄、前列腺再增生、膀胱功能障碍,正确的术前诊断,术中和术后处理,可以有效的提高手术的质量,同时进行必要的术后随访,有利于减少排尿困难的发生。     

良性前列腺增生开放手术后排尿困难的原因和治疗

目的探讨前列腺增生术后排尿困难的原因和治疗方法。方法回顾52例前列腺术后排尿困难患者的诊断和处理。结果原因主要有膀胱颈狭窄、神经性膀胱功能障碍、腺体残留或复发、尿道狭窄。手术治疗45例,手术成功率100％。结论术前筛选出神经性膀胱功能障碍患者、加强手术技巧和术后处理是有效防止术后排尿困难的关键,经尿道手术是首选治疗方法。     

围手术期个体化训练对子宫内膜癌子宫切除术患者术后尿潴留的影响

目的探讨围手术期个体化训练对子宫内膜癌子宫切除后尿潴留的影响。方法选取2016年2月-2017年2月该院收治的80例子宫内膜癌患者为对照组,给予常规方法预防尿潴留;另选取2017年3月-2018年3月该院收治的90例子宫内膜癌患者为观察组,围手术期采用个体化训练预防尿潴留。两组均给予广泛子宫全切+盆腔淋巴清扫术,比较两组术后膀胱功能、残余尿量、尿潴留发生率及焦虑程度的差异。结果观察组自主排尿恢复时间、导尿管留置时间短于对照组,残余尿量少于对照组,膀胱功能优于对照组(P<0. 05)。观察组拔除导尿管时疼痛程度轻于对照组,尿潴留发生率低于对照组(P<0. 05)。观察组术后15 d的S-AI评分、T-AI评分均低于对照组(P<0. 05)。结论围手术期个体化训练能够促进子宫内膜癌子宫切除术患者术后膀胱功能的恢复,减少术后尿潴留的发生,减轻患者的焦虑情绪。     

减少前列腺切除术出血的几点措施

减少前列腺切除术出血的几点措施深圳市梅林医院（５１８０２３）黄小平何大新中山市中医院张冀桂前列腺增生症是男性老年人下尿路梗阻常见原因之一，除引起排尿困难外，常可并发急、慢性尿潴留、膀胱憩室、结石、肾积水、感染和肾功能损害，经中西医结合治疗无效时可考虑...     

直肠癌直肠系膜全切除术的临床病理依据及意义

目的 探讨直肠癌直肠系膜全切除术的临床病理依据.方法 对102例具有较完整临床病理资料行直肠癌直肠系膜全切除术直肠癌组织、癌旁组织、直肠系膜进行常规病理切片,分析直肠系膜与直肠癌的分化程度、临床分期、淋巴结转移的关系及治疗效果.结果 直肠系膜癌转移均与癌组织分化程度、临床分期、淋巴结转移有相关性(P<0.05).结论 直肠癌直肠系膜全切除术是治疗直肠癌的最佳途径,切除的直肠系膜的范围应根据Dukes分期、肿瘤的分化程度及肿瘤浸润肠壁的深度区别对待.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.