Congenital anomalies of the genitourinary tract

Genitourinary tract anomalies found at birth arise from a variety of sex differentiation disorders occurred during fetal development. It is important to know and identify common congenital anomalies of genitalia for disclosing underlying genetic and/or endocrine disorders of newborn at very early stage of life as well as for determining proper sex of neonate. This article presents several genital anomalies from an obstetric point of view and simply describes their handlings.     

Borderline genitourinary tract abnormalities

The ability to detect major malformations of the fetal urinary tract using diagnostic antenatal ultrasound is well-known. Serious obstructive or dysgenetic abnormalities are often clearly seen and their implications well-known. Less clear is the meaning of mild or minimal pyelectasis, unilateral renal agenesis, nonvisualization of the fetal bladder, and pelvic kidneys. Fetal pyelectasis rarely, if ever, is associated with a need for neonatal intervention if the diameter of the pelvis is less than 10 mm. Although mild pyelectasis occurs in up to 25% of Down syndrome fetuses, the risk of Down syndrome in the case of isolated pyelectasis in a low-risk population is less than 1 in 340. Mild pyelectasis by itself does not seem to justify invasive testing for fetal karyotype. Nonvisualization of the fetal bladder carries a high risk of renal agenesis or dysplasia, whereas unilateral renal agenesis and a fetal pelvic kidney seem to carry limited, if any, negative implications.     

Haemophilus influenzae in genitourinary tract infections

Haemophilus influenzae was isolated in pure or predominant culture from genital specimens from nine females and two males. Four of the females had vaginitis, two had IUD-related endometritis, one had an incomplete septic abortion, and one had probable urethral syndrome. Two males had urethritis.     

超声诊断鳃裂畸形

目的 探讨高频彩色多普勒超声诊断鳃裂囊肿及鳃裂瘘的价值。 方法 回顾13例鳃裂畸形患者的声像图表现,结合手术所见及病理结果进行对照分析。 结果 3例为鳃裂囊肿,超声表现为囊性团块伴或不伴长短不一的瘘管残迹;4例为鳃裂囊肿并瘘管,超声表现为囊性团块伴细管状通道;4例为鳃裂囊肿并感染,超声表现为囊性团块,内回声细密,壁厚,边不清;2例为鳃裂瘘。13例患者中,10例病灶位于颈前区,2例位于锁骨下前胸壁,1例位于右下颌后角后。超声诊断与术中所见符合率为84.62%(11/13),与病理结果符合率92.31%(12/13)。 结论 高频彩色多普勒超诊断鳃裂畸形准确、可靠,可作为首选影像学检查方法。     

女性泌尿生殖道疾病病原微生物感染分析

目的探讨女性泌尿生殖道疾病中支原体合并其他病原微生物感染的情况。方法对妇科门诊就诊的女性泌尿生殖道标本进行病原微生物检测和支原体培养检测，并对其合并其他病原微生物感染情况进行统计分析。结果支原体阳性675例，同时伴有其他病原微生物感染285例（42．2％），病原菌以肠杆菌为主（44．6％），其次为表皮葡萄球菌（32．2％）和金黄色葡萄球菌（20．4％），少见白色念珠菌（2．8％）和腐生葡萄球菌（1％）。结论女性泌尿生殖道支原体感染多合并其他病原微生物感染；应该重视对女性泌尿生殖道疾病的防治。     

Clinical evaluation of cefotaxime for therapy of lower respiratory tract infections

A clinical trial was designed to evaluate the efficacy and safety of cefotaxime, a new semisynthetic, broad-spectrum cephalosporin, in the therapy of community-and hospital-acquired pneumonias. Thirty-nine males (mean age, 65 years) were treated for 41 episodes of pneumonia. Only five patient did not have a serious underlying disease; 15 had two or more significant disorders. Sixty-six percent of these pneumonias were due to Streptococcus pneumoniae or Haemophilus influenzae. The minimal inhibitory concentrations for all bacterial isolates ranged from 0.008 to 4 micrograms/ml. Peak serum cefotaxime levels during therapy ranged from 12 to 124 micrograms/ml 1 h after a 1-g dose. Satisfactory bacteriological and clinical responses were observed in 85% of the cases. Four episodes of pulmonary superinfections due to cefotaxime-resistant gram-negative bacilli were noted, each in a patient being mechanically ventilated. Pseudomonas was involved in each of these superinfections, and three were fatal. No serious toxicity or adverse reaction to cefotaxime was seen. The results of this study suggest that cefotaxime is an affective and well-tolerated new cephalosporin antimicrobial agent for the therapy of pneumonia due to susceptible organisms.     

泌尿生殖道支原体感染和耐药性分析

目的了解淮安地区非淋菌性尿道炎(NGU)患者泌尿生殖道解脲脲原体(Uu)和人型支原体(Mh)感染状况以及耐药性。方法对426例患者泌尿生殖道支原体进行分离培养,并采用支原体药敏试剂盒分析其耐药性。结果 426例NGU患者支原体检出269例,总检出率63.1%,其中Uu检出率50.5%;Mh检出率2.1%;Uu、Mh混合型支原体检出率10.6%。女性总检出率65.2%,其中Uu、Mh和混合感染检出率分别是52.5%、1.8%和10.8%;男性支原体总检出率46.81%,Uu、Mh和(Uu+Mh)检出率分别是25.2%、2.3%和8.5%。男性、女性检出率比较,差异有统计学意义(P0.05)。支原体对强力霉素、交沙霉素、阿奇霉素和克拉霉素较为敏感。结论 NGU患者泌尿生殖道有较高的支原体感染率,且女性总检出率高于男性。支原体体外药物敏感试验可以指导临床泌尿生殖系支原体感染的治疗。     

泌尿生殖道支原体感染检测及药敏试验

目的了解本地区泌尿生殖道解脲脲原体（Uu）和人型支原体（Mh）的感染状况及药物敏感性,指导临床医生合理应用抗生素。方法应用法国生物梅里埃公司提供的IST试剂盒进行支原体鉴定及9种药物敏感检测,并对结果进行统计学分析。结果2410例门诊患者中检出支原体阳性者共1401例,总感染率为58．1％,其中Uu单独感染901例（占37．4％）,Mh感染85例（占3．5％）,Uu＋Mh混合感染415例（占17．2％）。交沙霉素和原始霉素敏感率最高,对Uu感染分别是98．8％和98．8％,对Uu＋Mh混合感染分别为86．9％和86．8％;环丙沙星敏感率最低,分别是6．4％和2．6％。结论支原体感染以Uu为主,交沙霉素和原始霉素敏感率最高,环丙沙星敏感率最低。临床应选用培养敏感的抗菌药物,提高治疗效果。     

Topics in perinatal genitourinary system ultrasound evaluation

Ultrasound is a helpful imaging tool for triaging and in most instances making a definitive diagnosis of abnormalities of the fetal and neonatal genitourinary systems. Ultrasound can define an abnormality found in a fetus or neonate as definitively related to the genitourinary system, guiding further workups. Ultrasound can be used to assuage clinical concern by showing normal anatomic findings or variants that can simulate abnormality. This article discusses necessary information to aid in ultrasound diagnosis in various areas of the perinatal genitourinary system including the kidneys, bladder, and genital system. It discusses some adrenal findings that may help in these diagnoses.     

泌尿生殖道支原体检测及药敏结果分析

目的了解解脲脲原体（Uu）和人型支原体（Mh）的感染情况及其对抗生素的敏感性,以指导临床合理用药。方法用珠海丽珠试剂有限公司提供的解脲脲原体和人型支原体分离鉴定、计数、药敏试剂盒进行支原体的分离鉴定、半定量计数、药物敏感性试验。结果615例标本中Uu阳性者292例（88．2％）、Mh阳性者8例（2．4％）、Uu＋Mh阳性者31例（9．4％）。2006年期间对9种抗生素,即克拉霉素、司帕沙星、左旋氧氟沙星、氧氟沙星、交沙霉素、强力霉素、美满霉素、罗红霉素、阿齐霉素的药物敏感率,Uu分别为90．8％、9．4％、21．0％、3．7％、65．4％、92．6％、96．9％、5．0％和16．7％;Mh分别为0．0％、33．4％、33．4％、33．4％、66．7％、100．0％、100．0％、0．0％和0．0％;Uu＋Mh分别为23．5％、5．8％、0．0％、5．9％、23．6％、88．2％、94．1％、0．0％和0．0％。结论克拉霉素、强力霉素和美满霉素对Uu敏感性较好,强力霉素和美满霉素对Mh敏感性较好。临床用药应根据支原体的种类和药物敏感性进行选择。