儿童嗜铬细胞瘤13例临床分析

儿童嗜铬细胞瘤１３例临床分析第一附属医院儿科林致华，张丽娜，胡国祥关键词嗜铬细胞瘤；儿童嗜铬细胞瘤是小儿继发性高血压原因之一，占小儿慢性高血压的０．５％～１％。早期治疗可获痊愈。１临床资料男９例，女４例，年龄６～１５岁，１２～１４岁９例。发病至就诊时...     

腎上腺外之嗜鉻細胞瘤(報告病案一例)

嗜鉻細胞瘤之了解較为近期,在1922年Labbe,Tinel与Doumer等氏曾首先描述嗜鉻細胞瘤之临床症状,1929年Shipley与Pincoffs二氏亦分别报告了腎上腺體貭瘤切除成功。1937年Beer,King与Prinzmetal氏指出突发性高血压症在突发期间,血浆中含有加压物貭(Presser substance),以后遂认为腎上腺體貭为此加压物貭之产生处。 腎上腺髓貭起源于胚胎的神經脊(Neural crest)之外胚叶,其原始组织为成嗜鉻細胞(Phecochromoblast),后发展成为嗜鉻細胞(Phecochromocytes)。     

诊断嗜鉻细胞准确率近100%

诊断嗜鉻细胞准确率近100%     

小儿嗜铬细胞瘤10例分析

小儿嗜铬细胞瘤１０例分析哈尔滨医科大学二院儿内科黄素芳，孔宪娟，刘桂琴，谢英志嗜铬细胞瘤是一种发生在嗜铬细胞的肿瘤，能分泌过多的儿茶酚胺，临床症状是由于血循环中肾上腺素和去甲肾上腺素过多所致。一般都有明显的持续性或阵发性高血压，掌握本病在小儿中的特点...     

嗜铬细胞瘤10例分析

本文报告了我院自1962至1985年收治的有病理诊断的嗜铬细胞瘤10例。其中,肿瘤位于肾上腺7例,主动脉分叉处2例,主动脉旁1例。位于肾上腺的肿瘤浸及肾脏者1例,手术后近期死亡者1例。对本病的诊断、合并糖尿病及疑似甲状腺机能亢进的诊治,以及小儿嗜铬细胞瘤的特点进行了讨论。     

嗜铬细胞瘤所致儿茶酚胺性心肌病

本文就三例嗜铬细胞瘤所致儿茶酚胺性心肌病的尸检例。总结了本病临床病理的特点,并就本病的心肌受累部位、病变性质、发生机制、心肌病变与嗜铬细胞瘤的关系进行了探讨。提出嗜铬细胞瘤所致儿茶酚胺性心肌病的病变程度与嗜铬细胞瘤的体积无正相关。     

嗜铬细胞瘤的差异蛋白组研究

目的用蛋白质芯片技术筛选嗜铬细胞瘤患者血浆中特异性标志蛋白,寻找嗜铬细胞瘤特异性早期诊断方法。方法采用美国赛弗吉公司表面增强激光解析离子化飞行时间质谱技术(SELDI-TOF-MS)和WCX2芯片,检测嗜铬细胞瘤患者和合并高血压的其他肿瘤患者血浆蛋白质的相对含量。结果5例嗜铬细胞瘤患者与肾上腺皮质肿瘤和肺癌患者相比,血浆蛋白表达谱中可见一处差异峰,其分子量约为7 736 Da。手术后60 min,2例嗜铬细胞瘤患者该峰峰度降低,1例嗜铬细胞瘤患者该峰消失。结论血浆蛋白表达谱中分子量约为7736 Da的蛋白峰可能是嗜铬细胞瘤的特异性生物标志物。SELDI技术提供了为嗜铬细胞瘤诊断筛选标志蛋白组的可能。     

肾上腺偶发嗜铬细胞瘤

通过对21例肾上腺偶发嗜铬细胞瘤临床资料的分析,将肾上腺偶发瘤分为功能性嗜铬细胞瘤和静止型嗜铬细胞瘤,认为肾上腺偶发嗜铬细胞瘤诊断主要依靠影像学诊断,早期手术治疗预后较好.     

膀胱嗜铬细胞瘤的诊治

嗜铬细胞瘤主要来源于肾上腺素能系统嗜铬细胞，在异位嗜铬细胞瘤中，膀胱嗜铬细胞瘤较少见。本文就膀胱嗜铬细胞瘤其发病原因、临床病理特点、诊断、治疗以及预后等概况进行综述。     

多发复发及恶性嗜铬细胞瘤

目的：探讨多发复发及感性嗜铬细胞瘤的特点，提高诊疗效果。方法：回顾性分析23例多发、复发及恶性嗜铬细胞瘤资料。结果：23例多发、复发及恶性嗜铬细胞瘤占同期嗜铬细胞瘤的18．4％(23／125)。多发性嗜铬细胞瘤11例，其中位于肾上腺6例，腹后壁5例，6例为单发嗜铬细胞瘤筋后单发肾上腺或腹后壁肿瘤。恶性嗜铬细胞瘤6例。结论：多发、复发嗜铬组织肿瘤存在同时多发和异时复发的可能，为良性肿瘤，而非嗜铬组织的多发、复发则为恶性嗜铬细胞瘤。     

儿童嗜铬细胞瘤18例诊治分析

目的：对18例儿童嗜铬细胞瘤的诊治进行回顾性分析。以提高诊断和治疗水平。方法：分析18例患儿的临床表现。化验室检查及经腹膜后充气造影，B超，电子计算机体层扫描（CT），磁共振成像（MRI）检查定位诊断。结果：18例主要临床表现有剧烈头痛，心慌，多汗和视物模糊等，症状凶险，血压波动大，常有恶性高血压发作，香草苦杏仁酸（VMA）增高16例（16/18例），血和尿儿茶酚胺增高12例（12/13例），18例均经手术治疗，切除肿瘤19个，肿瘤重达40-150g。术后随访1-20年，血压恢复正常17例，占94?7/18例），1例2年后肿瘤复发，诊断为恶性嗜铬细胞瘤，第3年死亡，结论：儿童嗜铬细胞瘤临床少见，与成人相比表现不典型，常伴心脏损害。对儿童高血压患者应考虑到有本病的存在，并进行相应检查。争取早期确诊。     

青年高血压患者临床特征分析

背景　青年高血压发病率逐年上升,但对于青年高血压人群的认识和重视不足,目前尚无专门针对青年高血压的防治指南。目的　了解青年高血压患者的临床特征,为青年高血压早期诊断和治疗提供建议与参考。方法　选取2016—2017年在阜外医院高血压中心因高血压首次住院、年龄≤35岁的患者875例为研究对象。收集患者一般临床资料、病因类型、并发症及靶器官损伤相关指标。结果　共入组875例青年高血压患者,其中原发性高血压624例（71.3%）,继发性高血压251例（28.7%）。原发性高血压中男性患者451例（72.3%）,继发性高血压中男性患者168例（66.9%）。251例青年继发性高血压中最常见病因为阻塞性睡眠呼吸暂停（OSA）,随后依次为肾血管性高血压（RAS）、原发性醛固酮增多症（PA）、主动脉狭窄、多囊卵巢综合征及肾实质性高血压,其他少见病因包括甲状腺功能异常、库欣综合征、Liddle综合征及嗜铬细胞瘤。与原发性高血压相比,继发性高血压入院血压高,并发肾功能不全、心力衰竭、主动脉夹层、外周动脉狭窄/闭塞比例高,差异有统计学意义（P<0.05）。结论　原发性高血压是青年高血压的主要病因,男性患者多见,接近1/3的患者具有高血压的继发性因素,OSA、RAS、PA是继发性高血压三大主要病因。继发性高血压较原发性高血压患者血压水平高、靶器官损伤重。     

The use of herbal teas and remedies in Jamaica

We investigated the prevalence of the use of herbs among adults and children in Jamaica in 1996. Two concurrent surveys were conducted in randomly selected urban and rural areas: among adults and among caretakers of young children. From over 90% of the selected households, all caretakers of children under 6 years and one randomly selected adult (18 years or older) were interviewed using structured questionnaires. The 457 adults reportedly used 156 types of herbs: a mean of 6 +/- 3 (mean +/- standard deviation) by the urban adults, and 10 +/- 6 by the rural adults (t-test, p < 0.001). Almost 100% of respondents had at some time used herbs for teas or for treating illnesses. The most common method of preparation was by infusion or boiling in water, then adding sugar. Urban respondents, women and those who were employed were more likely to buy medicines than to use herbal remedies. One hundred and sixty-seven caretakers of 203 children under 6 years were interviewed. The mean number of herbs given to each child was between 2 and 3. The most common herbs were introduced within the first 6 months of life. Many caretaker factors were associated with herbal use. Public health implications include the potential toxicity of some herbs, the possibility that herbal teas given to young children may displace more nutritious foods and delay presentation to health care facilities. The findings will allow policy makers to target those most likely to use herbal preparations or to give them to young children, and target herbs to be analyzed for toxic or beneficial properties.     

膀胱恶性非上皮性肿瘤的诊断及治疗

目的 探讨恶性膀胱非上皮性肿瘤的临床诊断、治疗方法及与预后的关系.方法 回顾性分析从1974-2007年17例恶性膀胱非上皮性肿瘤的临床资料及随访结果.结果 17例患者中横纹肌肉瘤10例,恶性淋巴瘤2例,恶性嗜铬细胞瘤2例,平滑肌肉瘤2例,癌肉瘤1例.10例膀胱横纹肌肉瘤患者大多行手术、放疗及化疗的综合治疗,其中7例<5岁,5例随访8年仍存活,2例失访;3例成人膀胱横纹肌肉瘤均于1年内出现全身多发转移死亡.2例膀胱恶性淋巴瘤均采用膀胱部分切除术,术后行放疗或加化疗,随访3年均存活.2例膀胱恶性嗜铬细胞瘤中1例行转移淋巴结切除术加化疗,随访5年存活;另1例因转移的淋巴结未能切除,术后行放疗,2年后死亡.2例膀胱平滑肌肉瘤只行单纯手术治疗,分别随访1、5年均无瘤存活.1例膀胱癌肉瘤术后行化疗,1年内死亡.结论 恶性膀胱非上皮肿瘤以膀胱横纹肌肉瘤多见,幼儿多发,成人预后较幼儿差;其他类型肿瘤少见.不同的病理类型其治疗效果和预后不同.     

Cluster of Haemophilus influenzae type b infections in adults

Haemophilus influenzae type b commonly causes illness in young children, among whom transmission is known to occur. Most adults are believed to be immune to H influenzae type b and outbreaks of disease among adults appear to be uncommon. From July 14 to Aug 12, 1985, a cluster of six cases of acute febrile illness with cultures positive for H influenzae, biotype II (five cases) or untyped H influenzae (one case), occurred among adults in a nursing home and an adjoining hospital. All six case-patients had personal contact with at least one other case-patient. Among the 46 nursing home residents, men were more likely than women to become ill (44% vs 0%). This cluster of disease suggests that elderly adults may be more susceptible to H influenzae infection than is generally recognized and that outbreaks among adults may result from person-to-person transmission.     

Invasive pneumococcal disease in Indigenous people in north Queensland: an update, 2005-2007

OBJECTIVE: To examine trends in invasive pneumococcal disease (IPD) in Indigenous people in north Queensland following the introduction of the 7-valent pneumococcal conjugate vaccine (7vPCV). DESIGN: Trends in IPD were compared over three 3-year periods: before the introduction of 7vPCV for Indigenous children (1999-2001), and two consecutive periods after its introduction (2002-2004 and 2005-2007). MAIN OUTCOME MEASURES: Incidences of IPD in Indigenous children and adults in 1999-2001 and 2005-2007; trends in IPD caused by 7vPCV and non-7vPCV serotypes; and trends in indirect protective effects and emergence of non-7vPCV serotype IPD. RESULTS: From 1999-2001 to 2005-2007, there was a 60% decline in IPD, with the virtual elimination of 7vPCV serotype IPD in young (< 5 years) Indigenous children. There is no evidence yet of an increase in non-7vPCV serotype IPD in these children. Although the annual incidence of IPD in Indigenous adults remained virtually unchanged, there was a 75% decline in 7vPCV serotype IPD in these adults (chi2(trend) = 11.65, P < 0.001). However, the incidence of IPD caused by non-7vPCV serotypes more than tripled in adults (chi2(trend) = 7.58, P = 0.006). Serotype 1 IPD has been prominent over the 9 years, but there is no evidence of a recent increase in serotype 19A IPD. CONCLUSIONS: Vaccinating Indigenous children with 7vPCV has protected Indigenous adults in north Queensland through an indirect "herd immunity" effect. However, this benefit has been offset by a recent increase in non-7vPCV IPD in Indigenous adults. Newer pneumococcal conjugate vaccines could prevent, both directly and indirectly, a considerable amount of the persisting IPD in Indigenous people in the region.     

Diarrheal deaths in the United States, 1979 through 1987. A special problem for the elderly

OBJECTIVE.--Diarrhea is an important cause of death among young children in both developing and developed countries, but little is known about diarrheal death among adults. In this study, we examined trends in diarrheal deaths among all age groups in the United States. DESIGN/SETTING/PARTICIPANTS.--We reviewed national mortality data complied by the National Center for Health Statistics, Hyattsville, Md, which consists of information from all death certificates filed in the United States for the period 1979 through 1987. A death for which diarrhea was listed as an immediate or underlying cause was considered a "diarrheal death" and included in the analysis. RESULTS.--We found that 28,538 persons died of diarrhea cited as either an immediate or the underlying cause of death during the 9-year period. A majority of diarrheal deaths occurred among the elderly (older than 74 years of age, 51%), followed by adults 55 to 74 years of age (27%), and young children (younger than 5 years of age, 11%). For the elderly, adjusted risk factors for dying of diarrhea included being white, female, and residing in a long-term care facility. Only the elderly and young children had clear, distinct winter peaks of diarrheal deaths, suggesting that the diarrhea may, in part, be infectious in origin. CONCLUSION.--For the elderly, more directed studies of those at risk, such as nursing home residents, are needed to determine if oral rehydration therapy, vaccines, or other preventive measures might benefit this population.     

Normative data of olfactory abilities using cultural adaption Sniffin’ sticks smell test in different age groups

Objectives:To assess olfactory abilities using a culturally adapted Sniffin’ Sticks smell test in different age groups.Methods:This was a cross-sectional study, conducted at Otorhinolaryngology outpatient clinic of Universiti Kebangsaan Malaysia Medical Centre, Secondary Science School, and Children Learning Centre in Kuala Lumpur, Malaysia, from August 2019 until December 2021.Results:In 450 healthy participants, the cut-off points of the threshold discrimination identification (TDI) scores at the 10th percentile for olfactory abilities were 19 in children, 30.1 in adolescents, 32.1 in young adults, 31.1 in middle-aged adults, and 28.6 in older adults. The children had significantly lower olfactory abilities, with the Bonferroni post-hoc tests of p<0.001. The young adults had higher olfactory abilities than older adults (p<0.05). The results showed that the identification score was highest in middle-aged adults (p<0.001). The discrimination score was the highest in young adults (p<0.001). The best odor threshold performance was observed in adolescents (p<0.001). The TDI score showed a significant difference in olfactory abilities between men and women (p=0.001).Conclusion:Using a culturally adapted smell test, our population was able to identify, discriminate, and perceive odorants better than the European population. This data will help clinicians and researchers with a tool to reliably establish the correct results of olfactory function in our population. Women had better olfactory abilities than men.     

深圳市福田区2006～2007年麻疹疑似病例血清学检测分析

目的了解麻疹流行特点,加速麻疹控制,完善今后麻疹监测工作。方法对2006～2007年福田区麻疹疑似病例进行血清学检测分析。结果2007年麻疹发病率较2006年呈上升趋势,青壮年（16～35岁）是成人麻疹高发人群。样品采集时间对检测结果有影响,出疹后1d内采血样品阳性率最低。结论麻疹发病率有上升趋势,5岁及以下儿童及青壮年是麻疹防控重点人群。麻疹血样注意避免出疹后1d内采集。