Analysis of Nine Cases of Acute Thallium Poisoning

In this study nine cases of thallium poisoning in a series of homicidal poisoning were analyzed in order to provide more information concerning thallium poisoning. It was found that the most common clinical feature of thallium poisoning was peripheral neuropathy and paraesthesia was more common than amyasthenia. Understanding of these clinical characteristics of thallium poisoning was helpful to early identification and differential diagnosis. Since the early administration of Prus- sian Blue, as a specific antidote for thallium poisoning, can substantially improve the prognosis, it is of great importance to establish a correct and early diagnosis.     

A Retrospective Study of 60 Hospitalized Cases with Pemphigoid

Ｉｎｔｈｉｓｒｅｐｏｒｔ,ｗｅｒｅｔｒｏｓｐｅｃｔｉｖｅｌｙｓｔｕｄｉｅｄ 6 0ｃａｓｅｓｗｉｔｈｂｕｌｌｏｕｓｐｅｍｐｈｉｇｏｉｄｗｈｏｗｅｒｅｈｏｓｐｉｔａｌｚｅｄｉｎＰＵＭＣｈｏｓｐｉｔａｌｆｒｏｍ 1980ｔｏ 1998,ｔｏｌｅａｒｎｔｈｅｃｌｉｎｉｃａｌａｎｄｌａｂｏｒａｔｏｒｙｆｅａ ｔｕｒｅｓｏｆｂｕｌｌｏｕｓｐｅｍｐｈｉｇｏｉｄ ,ｉｔｓｒｅｌａｔｉｏｎｓｈｉｐｗｉｔｈｏｔｈｅｒｄｉｓ ｅａｓｅｓ ,ａｎｄｔｏｆｉｎｄａｒｅｌａｔｉｖｅｌｙｒｅａｓｏｎａｂｌｅｔｈｅｒａｐｙｒｅｇｉｍｅｎｆｏｒｔｈ…     

Surgical Treatment of Aortic Aneurysm and Aortic Dissection： A Retrospective Analysis of 122 Cases

The study summarizes the clinical experience of surgical treatments of various types of thoracic aneurysm and aortic dissection. Clinical data of 122 patients with thoracic aneurysm and aortic dissection during July 2005 to July 2008 were retrospectively analyzed. The elective operations were performed in 107 patients while emergency surgery was done in 15 cases. Different surgical strategies were employed on the basis of diseased region, including simple ascending aortic replacement （n=3）, aortic root replacement （n=43）, hemi-arch replacement/total arch replacement ＋ elephant trunk technique （n=32）, thoracic/thoracoabdominal aortic replacement （n=8） and endovascular repair （n=36）. In this series, there is 4 cases of perioperative death due to massive cerebral hemorrhage （n=1）, respiratory failure （n=1） and multiple organ dysfunction syndrome （MODS） （n=2）. Three cases developed post-operative massive cerebral infarction and the relatives of the patients abandoned treatment. Instant success rate of endovascular repair was 100%. The intimal rupture was sealed. Blood flow was unobstructed in true lumen and no false lumen was visualized. It was concluded that aggressive surgery should be considered in the patients with thoracic aneurysm and aortic dissection. Surgical procedures should vary with the location and the nature of the lesions.     

肾上腺髓质增生合并无功能皮质腺瘤2例

报告2例肾上腺髓质增生合并无功能皮质腺瘤患者，均经右12肋切口行右肾上腺切除术。术后患者生活良好，随访半年，高血压恢复正常水平。因此，肾上腺髓质增生合并无皮质腺瘤的诊断需结合临床表现和辅助检查进行综合判断，CT是首选方法，同时可了解对侧肾上腺解剖结构；手术切除是主要治疗方法，多数预后良好。     

IVF-ET, TET, and GIFT in an Oocyte Donation Program：A Retrospective Analysis of 106 Cases

We have reviewed our experience with gamete intra fallopian transfer (GIFT), in vitro fertilization and uterine transfer (Ⅵ F-ET), and tubal embryo transfer (TET) with donated oocytes in 89 patients for a total of 106 cycles. The overall pergnancy rate of 45%, is significanty higher than that obtained during cycles in which patients undergo controlled ovarian hyperstimutation (COH) and the transfer performed with theirown gametes or embryos, A Clinical pergnaney rate per cycle of 37%, 48% and 57% were obtained in Ⅳ F-ET, GIFT, and T ET transfers, respectively. The regults of thisstudy do not show a clear superiority of any transJer technique over the others in casesof oocyte donation. No difference in pregnancy rate was noted according to recipient‘s age.     

Multiple Traumatic Intracranial Hematoma——A Clinical Analysis of 323 Cases

CT scan has its unique advantage for thediagnosis of multiple traumatic intracranial he-matoma, but it cannot be said that an early di-agnosis could not be made without CT scan. Ourdata support this opinion. A total of 323 patientswith multiple traumatic intracranial hematomawas treated from 1976 to 1988, with a mortality     

One Hundred and Six Cases of Chronic Gastritis Treated byAcupuncture

In recent years, the authors have treated 106 cases of chronic gastritis with acupuncture, and achieved satisfactory therapeutic results. A report follows.     

Treatment of Postmenopausal Osteoporosis with Yang Huo San Zi Tang—A Report of 30 Cases

From June 2000 to June 2003, 30 cases of postmenopausal osteoporosis (PMOP) were treated with Yang Huo San Zi Tang (羊藿三子汤) in a controlled study. The following is the clinical report with a brief discussion on its therapeutic mechanism.     

The TCM Remedies for Treatment of AIDS——A Clinical Report of 60 Cases

Objective: To evaluate the clinical effects of TCM remedies in treatment of acquired immune deficiency syndrome (AIDS). Method: 60 cases of AIDS or AIDS-related complex (ARC) were divided into four different TCM patterns and treated accordingly. Results: Of the 60 cases, 52 patients (86.7%) experienced remarkable improvement in general symptoms and lab findings, including virus loading and CD4 T lymphocyte count. Conclusion: The TCM remedies could definitely improve the symptoms and signs of AIDS or ARC, enhance the immune function, decrease the possibility of contracting opportunistic infection, improve the life quality, and prolong the survival period, with no apparent toxic and side effects.     

Analysis of 23 cases of pulmonary cryptococcosis

Pulmonary cryptococcosis (PC) is a subacute or chronic pulmonary fungitis caused hy Cryptococcus neoformans.Because of no specific clinical symptoms or manifestaions in chest radiographs, misdiagnosis is common. Between January 1980 and january 2004, 23 eases of PC were diagnosed by pathological examinations in our hospital and the clinical data were retospectively analyzed to inprove the diagnosis of PC.     

肾上腺皮质腺瘤和结节性增生的CT诊断(附4O例分析)

为探讨皮质腺瘤和结节性增生之间的CT鉴别诊断，对40例经手术病理证实的肾上腺皮质腺瘤和结节性增生病例的CT表现进行分析。结果显示CT的定性诊断准确率为92．5％。提示：CT扫描可以从病灶的密度、强化程度、大小、有无包膜和对侧腺体有无萎缩或增大等征象来鉴别腺瘤和结节性增生。     

Adrenal cortical and medullar hyperplasia—A retrospective analysis of 6 cases

Summary The features of the symptoms, laboratory tests and pathological characteristics of adrenal cortical and medullary hyperplasia were studied. In 6 cases of hypercatecholaminenia, plasma norepinephrine (NE), epinephrine (E), catecholamine (CA) and 24-h urinary vanillylmandelic acid (VMA), 17-hydroxycorticosteroid (OHCS) and 17-ketosteroid (KS) were determined. Adrenal glands were examined by CT scan and¹³¹I-MIBG imaging. Pathological examination was performed after operation. The results showed that in 6 cases of hypercatecholaminenia (3 men and 3 women) aged from 34–50 years, the clinical features were just like “pheochromocytoma”, for example, episodic headache, perspiration, palpitation, pallor, apprehension, nausea, tremor, anxiety and so on. Plasma levels of CA, NE and E were elevated in all 6 cases. 24-h urinary samples obtained at the onset revealed elevated VMA in 1 case. 24-h urinary cortisol was obviously elevated in all 6 cases. 24-h urinary 17-OHCS, 17-KS was normal. B-type ultrasound, CT, MRI and¹³¹I-MIBG revealed 9 lateral adrenal gland diffuse or nodular enlargement in 6 cases. Pathologic examination showed adrenal cortical and medullary hyperplasia. Clinically, adrenal cortical and medullary hyperplasia resembled “pheochromocytoma”. The most significant feature of this disease was both elevated plasma CA and 24-h urinary cortisol obviously. Pathologic examination showed adrenal cortex nodular hyperplasia and medullar diffuse or limit hyperplasia. Whether it is an independent disease or symptoms of the other disease has not final conclusion up till now     

肾上腺转移癌18例临床分析

目的探讨肾上腺转移癌的临床特点与诊治方法。方法对1992年至2003年收治的18例肾上腺转移癌患者的病理、临床表现、治疗及预后进行回顾性研究。结果肾上腺转移癌原发肿瘤中肺癌7例，肝癌4例，乳腺癌3例，肾癌2例，胃癌和胆管癌各1例。临床表现为腰背部胀痛5例，乏力、消瘦3例。完整切除肾上腺转移癌的8例患者术后平均生存期（28个月）比非手术组（9．5个月）长（P〈0．05）。结论肾上腺转移癌患者大多无特异性临床症状；B超和CT在肾上腺转移癌的诊断中具有重要作用；外科手术可延长患者生存期。     

肾上腺性性征异常的诊断与治疗

目的：探讨肾上腺性性征异常的诊断、鉴别诊断和治疗，特别是分泌性激素的肾上腺肿瘤的良恶性鉴别诊断和各种先天性肾上腺增生疾病的治疗原则。方法：报告1986年-1996年8例先天性肾上腺皮质增生和5例分泌性激素的肾上腺肿瘤的诊治经验。结果：先天性肾上腺皮质增生中有3例17—α羟化酶缺乏症，肿瘤患包括2例女性男性化、3例男性女性化肾上腺肿瘤。分泌性激素肾上腺肿瘤均经手术切除。结论：分泌性激素的肾上腺皮质肿瘤的重量、直径(DHEA)、尿17酮和血性激素水平、CT表现和肿瘤浸润及转移可作为判断肿瘤良恶性的参考指标。对大体积肾上腺肿瘤首选改良肋缘下切口。先天性肾上腺皮质增生应根据疾病类型而选用不同皮质激素进行治疗，对于17—α羟化酶缺乏的病例。儿童期至青春期不宜应用性激素治疗。     

肾上腺囊肿3例报告

通过３例肾上腺囊肿的临床诊治，对这一少见疾患的病因病理及诊断治疗进行总结。根据病理检查结果，肾上腺囊肿有４种类型：内皮性、假性、上皮性及寄生虫性。肾上腺囊肿的临床诊断依靠Ｂ超、ＣＴ扫描或ＭＲＩ，实验室检查囊肿有否内分泌功能。对体积小、临床症状轻的病者可定期随访；对体积大、临床症状明显的患者可行穿刺及囊腔硬化治疗或手术切除；如囊肿具内分泌功能、囊液性质不定（或血性或粘稠）、囊壁厚而不规则等应手术探查。手术应在尽可能多地保留肾上脓组织、不损伤肾脏及周围器官的原则下，完全摘除囊壁或整个囊肿。     

86例肾上腺偶发瘤临床分析

目的 提高肾上腺偶发瘤（AI）的诊断与鉴别诊断水平,指导临床治疗。方法 回顾性分析我院2005年1月至2011年12月因健康体检或肾上腺疾病以外原因就诊发现的86例肾上腺偶发瘤患者的临床资料,并复习国内外相关文献。结果 86例AI患者中84例（97.7%）接受手术治疗,后腹腔镜手术55例（64.0%）,其中4例中转开放手术,有内分泌功能肿瘤37例（43.0%）,术后病检确诊皮质腺瘤40例,嗜铬细胞瘤24例,髓性脂肪瘤8例,囊肿5例,皮质腺癌2例,肾上腺皮质结节样增生2例,转移性肿瘤1例,血管平滑肌脂肪瘤1例,神经节细胞瘤1例。81例良性肿瘤随访1-6年未见复发,3例转移性肿瘤均在2年内死于原发肿瘤,2例皮质腺癌中1例术后11个月死于广泛转移,1例随访2年3个月仍存活。结论 影像学检查结合内分泌检测有助于AI的定位及定性诊断,明确诊断的〈3cm的肾上腺囊肿、血肿及髓性脂肪瘤可随访观察除外,其余AI均应积极手术,腹腔镜手术是AI的首选术式。     

肾上腺偶发瘤138例临床诊疗回顾性分析

回顾性分析138例肾上腺偶发瘤患者的临床资料,并随访术后恢复情况,探讨肾上腺偶发瘤的诊断和治疗方法.     

肾上腺肿瘤及增生27例诊治经验

27例肾上腺肿瘤及增生中皮质醇症8例、嗜铬细胞瘤16例、原发性醛固酮增多症、髓质增生症及无功能性肿瘤各1例。定位诊断主要为CT检查及腹膜后注气造影。皮质醇症术前应有效地控制血糖;嗜铬细胞瘤术前使用皮质激素有助于患者顺利地度过手术关。本组患者以手术治疗为主,并阐述了手术治疗的经验。     

肾上腺肿瘤与增生的CT对比研究

收集了经手术病理与临床追踪证实的65例肾上腺肿瘤与增生病例CT表现进行回顾性分析研究。旨在分析肾上腺肿瘤与增生的CT表现,以提高对其诊断与鉴别诊断水平。表明肾上腺肿瘤常为低密度或不均匀密度,增强扫描仅轻度均匀强化或不均匀强化,肿瘤常大于1cm,良性肿瘤形态规则,恶性肿瘤形态不规则,肿瘤可使同侧、对侧腺体萎缩及侵犯周围邻近组织。肾上腺增生常为等密度,增强扫描为均匀强化,增生腺体常小于1cm,形态规则,无包膜,与周围正常腺体分界不清楚,腺体增生可以单侧或双侧。结果提示肾上腺肿瘤与增生在密度、大小、形态、强化程度及与周围腺体关系均有显著不同。     

肾上腺皮质激素治疗肝衰竭的疗效观察

目的探讨肾上腺皮质激素治疗肝衰竭的临床疗效。方法在综合治疗的基础上使用肾上腺皮质激素。开始3 d每日使用地塞米松10 mg静脉滴注,以后隔日1次注射地塞米松5 mg,待临床症状好转,总胆红素水平减退至患者最高峰值的一半以下时,改用地塞米松3～5 mg,间隔48～72 h一次,治疗组32例与对照组35例患者比较临床症状、生化指标好转情况及住院时间和费用情况。结果治疗组症状及生化指标好转率高于对照组,差异有统计学意义(P<0.05);两组并发症的发生率无统计学差异(P>0.05);治疗组患者的住院时间及费用低于对照组,差异有统计学意义(P<0.05)。结论激素冲击疗法治疗肝衰竭,疗程短、疗效/成本比高、不良反应少。