28例急性衣原体性附睾炎的诊治及预后

目的探讨急性衣原体性附睾炎的诊断、治疗及预后。方法采用衣原体培养法确诊急性衣原体性附睾炎,用大环内酯类抗生素加皮质激素,双疗程治疗,3~6个月后检测精液质量以考察急性衣原体性附睾炎对生殖力的影响。结果28例患者治疗2周后症状消失,治疗3~6个月后24例患部未扪及结节,2例复发患者症状改善。治疗组精液参数与对照组无统计学差异。结论大环内酯类抗生素加用皮质激素双疗程能有效控制急性衣原体性附睾炎,患者经积极正规治疗后对生殖力未见明显影响。     

Nongonococcal urethritis. A clinical review

The rising incidence of nongonococcal urethritis (NGU) and the risk of potential complications attributed to chlamydial carriage are of great concern to public health officials. Recognition of Chlamydia trachomatis as a serious, sexually transmitted pathogen has come more recently, and this agent may be responsible for many cases of epididymitis, prostatitis, pelvic inflammatory disease, Reiter's syndrome, infant pneumonia, and possibly other complications. This review describes the clinical manifestations of NGU compared with gonococcal urethritis and the means of diagnosis and management in the patient and his sexual partners. The chlamydial etiology of NGU and other possible etiologies are also discussed.     

儿童急性附睾炎的诊断及治疗体会

目的 探讨儿童急性附睾炎的早期诊断和治疗.方法回顾分析近4年内我院收治的28例急性附睾炎儿童临床资料.结果 共收治28例急性附睾炎儿童,占同期收治的60例急性阴囊疼痛患儿的46.7%.26例急性附睾炎患儿实施保守治疗,1例急性附睾炎患儿进行手术探查后排除了睾丸及附睾扭转,1例患儿因病情严重行手术减压术挽救睾丸.结论 急性阴囊疼痛、肿胀是一个潜在的手术急症,急性阴囊疼痛患儿中急性附睾炎并不少见,早期就诊,早期明确诊断可以避免手术治疗.     

高频彩色多普勒超声对急性附睾炎诊断的临床价值

目的探讨高频彩超对于急性附睾炎诊断的实用性。方法回顾性分析既往49例急性附睾炎病人进行的高频彩色多普勒超声检查的影像资料;同时选择49例健康者作为对照组。结果急性附睾炎表现为附睾不同程度肿大,多位于附睾尾部,附睾头部及体部较少见。病灶处超声表现多为偏低回声,表现为弥漫性和（或）结节状,部分患者同时合并有睾丸炎、鞘膜积液、精索静脉曲张等。急性附睾炎彩色多普勒显示肿大的附睾内血流信号丰富,最大血流速度、阻力指数均和正常附睾有显著差异。结论高频彩超是检查急性附睾炎的首选方法,诊断符合率高、特异性较强,具有极高的临床应用价值。     

清胆和胃丸中芍药苷和黄芩苷含量测定的研究

目的：建立同时测定清胆和胃丸中芍药苷和黄芩苷含量的高效液相色谱法。方法：采用VenusilXBPC18（L）柱（4．6mmx250．0mm,5μm）;以甲醇（A）和0．1％磷酸水溶液（B）作流动相,梯度洗脱;柱温：30℃;流速：1．0mL·min-1;检测波长：230nm。结果：芍药苷的线性范围为0．2635～1．8446μg（r=0．9999）,黄芩苷的线性范围为0．2830—1．9807μg（r=0．9999）;平均加样回收率（n=5）分别为96．76％、96．54％,RSD分别为0．9664％、0．4517％。结论：所建立的方法准确、快速,可用于清胆和胃丸的质量控制。     

高频彩超和超声造影在急性附睾炎诊断和评估中的价值研究

目的 探讨高频彩超和超声造影在急性附睾炎诊断和评估中的临床价值。方法 回顾性分析经临床证实的急性附睾炎患者的高频彩超和超声造影特征,并分析健患两侧附睾超声造影定量参数的差异。结果 典型急性附睾炎表现为患侧附睾不规则增大,回声减低,血流信号明显增多增密,频谱呈高速低阻状态;超声造影呈"快进慢出"的特征,患侧附睾造影剂开始增强时间和达峰时间早于健侧附睾,消退时间晚于健侧附睾,达峰强度和曲线下面积高于健侧附睾,差异均有统计学意义（P<0.05）。结论 超声造影可清晰显示急性附睾炎的血流灌注特征,超声造影定量参数可准确反映健患两侧附睾血流灌注的差异,在急性附睾炎早期诊断和并发症的评估方面可以为临床医生提供帮助,超声造影结合高频彩超对准确诊断和评估急性附睾炎具有重要的参考价值。     

胸腺法新联合抗生素治疗急性附睾炎的临床疗效

目的 观察采用胸腺法新联合抗生素治疗急性附睾炎患者的临床疗效。方法将本院138例急性附睾炎患者,按照治疗措施不同将患者分为对照组109例和观察组29例。其中对照组主要应用抗生素治疗方案,观察组在对照组基础上加用胸腺法新,比较两组临床疗效。结果对照组总显效例数为87,显效率为79.8%;观察组显效28例,仅有1例无效,显效率为96.6%,明显高于对照组(P<0.05)。两组在总住院时间,疾病复发及睾丸萎缩等后遗症方面没有明显差异。结论胸腺法新联合抗生素治疗急性附睾炎患者临床疗效明显,值得临床推广。     

超声与核素显像对急性附睾炎和睾丸扭转的鉴别

目的 比较彩色多普勒超声(CDU)与核素扫描对睾丸扭转和急性附睾炎的鉴别诊断价值。方法 分析比较ll例睾丸扭转和17例急性附睾炎的超声图像和核素扫描图像。结果 CDU诊断准确率为100％，核素扫描误诊3例，正确率为88．9％。结论 与核素显像相比，CDU具有准确率高，方便快捷，符合急诊手术需要，无射线损害等优点。     

手术治疗急性附睾炎43例临床观察

从1984年1月至1988年6月施行附睾切开术治疗急性附睾炎43例。本文对本病的病原菌、手术原则、超声多普勒检查以及麻醉方法进行讨论,认为附睾切开术是一种治疗急性附睾炎的有效方法,值得应用     

The occurrence of chlamydial and gonococcal salpingitis during the menstrual cycle

We evaluated 104 women hospitalized with a diagnosis of acute salpingitis to compare the relationship between the menstrual cycle and onset of acute chlamydial and/or gonococcal salpingitis and acute salpingitis associated with other facultative aerobic and anaerobic bacteria. Neisseria gonorrhoeae was recovered from 42 women (40%), Chlamydia trachomatis from 28 (27%), and nongonococcal, nonchlamydial organisms only from the upper genital tract in 48 (46%). Among 37 cases with symptoms of acute salpingitis within seven days of onset of menses, 30 (81%) had chlamydial and/or gonococcal infection. Of 35 cases with onset after 14 days postmenses, 23 (66%) had nongonococcal, nonchlamydial organisms only. Of the 28 women with chlamydial infection, 17 (57%) had the onset of disease within one week from the first day of their last menstrual period. Similarly, 23 (55%) of gonococcal infections had onset of symptoms within one week from onset of menses. However, only seven (14%) of the women with nongonococcal, nonchlamydial salpingitis reported onset of symptoms within one week. The temporal pattern of onset of chlamydial or gonococcal acute salpingitis showed significant differences when compared with the time of onset for nongonococcal, nonchlamydial acute salpingitis.     

睾丸扭转8例临床分析

目的 提高睾丸扭转的诊治水平。方法 回顾性分析8例睾丸扭转患者的临床资料。结果 5例首诊时误诊为急性附睾炎,7例经阴囊彩超确诊,1例经手术探查确诊。8例均予以手术治疗,6例行患侧睾丸切除,2例保留患侧睾丸,而对侧睾丸均行预防性固定。随访一年,2例保留的睾丸未发现萎缩及再次扭转,对侧睾丸均无扭转发生。结论睾丸扭转和急件附睾炎在临床表现上难以鉴别,彩超检查为确诊的首选方法。一旦疑诊睾丸扭转均应手术探查,以提高睾丸的存活率。     

The acutely painful scrotum in children: review of 113 consecutive cases

A young boy who presents with an acutely painful scrotum can be a diagnostic challenge to his physician. It is important to differentiate the various causes of this symptom and to institute prompt management. Failure to do so could jeopardize the patient's future fertility. In a review of 113 consecutive cases of a painful scrotum at a children's hospital, torsion of the testicle was found in 51 patients (45%). Torsion of the appendix testis was found in 40 patients (35%) and acute epididymitis, once considered rare in children, was diagnosed in 17 (15%). The importance of prompt diagnosis of torsion is emphasized. The clinical diagnosis of the acutely painful scrotum is notoriously difficult, and in this series of cases surgical exploration was required in 92%. Only 2 of the 17 cases of epididymitis were associated with a bacterial urinary tract infection.     

急性睾丸扭转的诊断和治疗

目的:探讨急性睾丸扭转的诊断和治疗。方法:回顾性总结分析12例急性睾丸扭转患者的临床资料。结果:12例患者均经彩色多谱勒血流成像检查,11例确诊为睾丸扭转,2例行手法复位成功,1例自动复位,2例手术复位成功,7例手术切除坏死睾丸。结论:彩色多谱勒血流成像是诊断急性睾丸扭转的可靠方法,早期诊断,早期复位是提高睾丸成活率的关键。     

Chronic asymptomatic Chlamydia trachomatis colonization of the fallopian tubes during the peripartum period

Antepartum cervical Chlamydia trachomatis infection is associated with an increased risk of peripartum maternal and neonatal morbidity. Chronic chlamydial salpingitis has been described in asymptomatic women. We studied the incidence of asymptomatic chlamydial colonization of the fallopian tubes during pregnancy, and the influence of such infection on the patients' clinical course, by culturing the fallopian tubes of 53 asymptomatic women who underwent tubal ligation in the immediate postpartum period. One patient had a positive chlamydial culture in one of her tubes, and two others had histologic evidence of acute and chronic salpingitis. These patients had no infectious morbidity during the antepartum, intrapartum, or postpartum periods. Our findings suggest that asymptomatic chlamydial colonization and inflammatory processes may exist in the fallopian tubes during the peripartum period.     

Ocular chlamydial infection in a university eye clinic.

In the University Hospital, Kuala Lumpur, from 1984 to 1990, 184 patients with acute conjunctivitis were examined for chlamydial infection by direct immunofluorescence. Overall, 52 (28.3%) were found to be positive for chlamydial antigen. There was no significant difference in the detection rate between men and women and among the 3 major ethnic groups. The detection rate was highest among sexually active adults. Epidemiological and clinical features suggest that most of the chlamydial ocular infections seen were inclusion conjunctivitis and not classical trachoma.     

高频彩超对小儿阴囊急症的诊断价值

目的探讨高频彩超对小儿阴囊急症的诊断价值。方法回顾性分析近年来我院用高频彩超检查的86例小儿阴囊急症病例。结果在本组病例中,急性睾丸炎30例,占34．8％;急性附睾炎21例,占24．4％;睾丸扭转19例,占22．1％;睾丸附件扭转11例,占12．8％;创伤5例,占5．8％．采用手术或保守治疗均治愈,无任何并发症。结论高频彩超具有方便无创、准确率高等优点,是小儿阴囊急症首选可靠的检查方法,可为临床选择正确的治疗方案,提供有价值的诊断依据。     

中西医结合治疗淋病36例

对36例急、慢性淋病性尿道炎、宫颈炎及合并前列腺炎、精囊炎、附睾炎等患者采用中西医结合的治疗方法,经1～4周的治疗,36例患者全部治愈.疗程短,效果好.     

93例附睾炎高频彩超表现及临床分析

目的探讨附睾炎的超声表现及其临床诊断价值。方法应用高频彩超仪,采取直接扫查法,左右两侧对比观察并测量附睾头、体、尾厚度,睾丸大小以及精索静脉宽度等,二维图像主要观察上述结构的形态、大小、回声表现,彩色多普勒主要观察病变部位的血流变化情况。结果 93例附睾炎患者中,附睾尾炎症（单独或并发）最为多见,共85例,占总数的91.5%;双侧附睾病变者26例,左侧附睾病变者37例,右侧附睾病变者30例;合并睾丸炎症者9例;精索静脉曲张者20例;鞘膜积液者12例。结论高频彩超诊断附睾炎快速、准确,简便易行,应作为本病诊断和鉴别诊断的首选方法。     

Diagnostic accuracy of hand-held Doppler in the management of acute scrotal pain

We evaluate the reliability of hand-held Doppler (HHD) in the management of acute scrotal pain of 24 h or less duration. Between October 2003 and December 2004, patients presenting with acute scrotal pain were enrolled in this prospective study. After clinical examination, all patients had a HHD assessment. Presence or absence of Doppler arterial signals and its intensity were recorded. A blinded assessor corroborated HHD findings with the clinical, ultrasound, operative findings and final diagnosis. Primary outcome measured were sensitivity and specificity of HHD in the diagnosis of testicular torsion. Twenty-five patients presented during the study period with acute scrotal pain. The final diagnosis was testicular torsion in nine, epididymitis in 13, twisted cyst of Morgagni in two and Henoch–Schoenlein purpura in one patient. The HHD predicted all patients of testicular torsion correctly, preoperatively. HHD is a reliable diagnostic tool in the management of patients with acute scrotal pain.     

The pathogenicity of Haemophilus somnus in various laboratory animal species

As a test of susceptibility of laboratory animals to the causative organism of thrombotic meningoencephalitis of cattle, young mice, rats, rabbits, piglets, chicks and hamsters were exposed to the virulent strain 43826 of Haemophilus somnus by the intravenous and intraperitoneal routes. Only the hamsters developed lesions attributable to the organism. Two of ten hamsters developed an acute orchitis and epididymitis characterized by necrosis and arteritis. The fact that Histophilus ovis, a cause of epididymitis in Australian and New Zealand rams, is apparently very closely related to Haemophilus somnus suggests that the hamster may be a useful laboratory model to study this disease.