METANEPHRIC ADENOMA IN CHILDREN： REPORT OF TWO CASES AND REVIEW OF LITERATURE

Metanephric adenomas are uncommon benign re-nal tumors. Relatively, the tumors are more involvedin adult females and rarely found in children. Theimaging characteristics of the lesions are lacking andhave not been described clearly. Now we reviewedthe man…     

PERITUMORAL CYSTIC MENINGIOMA： REPORT OF SIX CASES AND REVIEW OF LITERATURES

Objective Cystic meningiomas are quite rare. There is a great controversy concerning the management of the cystic wall. We reported six peritumoral cystic meningiomas and reviewed the literature to discuss the management of the cystic wall. Methods Six cases of peritumoral cystic meningiomas were retrospectively analyzed. Results Gadolinium-enhanced Tl-weighted magnetic resonance imaging scans disclosed the solid tumor enhancement in 3 cases, the cystic wall enhancement in 2 cases. One case only showed the cystic lesion. All the tumors were totally removed （ including the involved dura and partial cystic wall）. Histopathological examination showed 3 meningiotheliomatous meningiomas, 2 microcystic meningiomas, 1 mucoid degeneration. After operation, all the patients recovered well and demonstrated no neurological deficit. During the follow-up time, no tumor was recurrence. Conclusion Magnetic resonance imaging with contrast enhancement can provide information regarding whether surgical removal of the cystic wall is indicated. Peripheral enhancement of the cystic wall strongly indicates the presence of tumor infiltration. The removal of the entire cystic wall should be performed, excessive damage to brain be prevented.     

SURGICAL TREATMENT OF BLUNT CARDIAC TRAUMA IN CHILDREN： REPORT OF 2 CASES AND REVIEW OF LITERATURES

Objective Summarizing the clinical experience of surgical treatment in 2 cases of blunt cardiac trauma and reviewing the relevant literaturesMethods A 6-year-old girl was diagnosed muscular ventricular septal defect and left ventricular aneurysm 2d after automobile accident and underwent ventricular septal defect repair 2 weeks after injury. Another 9-year-old boy was diagnosed severe mitral regurgitation resulted from rupture of posterior papillary muscle 9d after automobile accident and underwent mitral valvuloplasty 2 weeks after injury. Results Heart function of the first patient was in New York Heart Association (NYHA) class Ⅰ, echocardiography showed no residual septal defect and the size of left ventricular aneurysm reduced. Heart function of the second patient is in NYHA class Ⅱ, echocardiography showed mild mitral regurgitation. Conclusion Blunt traumatic heart disease occurs either because of heart compression between sternum and the spine and/or because of myocardial contusion; A more aggressive strategy with surgical treatment earlier before deterioration of heart function is advocated; Earlier surgical correction of anatomic deformity will achieve a good result and a long time follow-up is necessary.     

URETERAL INJURY DURING GYNECOLOGICAL LAPAROSCOPIC SURGERIES： REPORT OF TWELVE CASES

GYNECOLOGICAL surgery is themajorcauseiatrogenic ureteral injury.More ureteral injurhave been reported these years as the frequenof gynecological laparoscopic surgeries is increasing.1Inmeta-analysis study,70cases in30published articles fro1966to2003were …     

CASTLEMAN＇S DISEASE IN THE RETROPERITONEAL AREA：REPORT OF 5 CASES AND REVIEW OF THE LITERATURE

Objective To investigate the diagnostic and treatment methods of Castleman＇s disease（CD）.Methods Five CD cases were treated in our department,we presented its clinical characteristics and had a comprehensive review of different reports from other centers.Results We presented five patients who had retroperitoneal mass and postoperative pathological results confirmed all of them had hyaline vascular（HV）type CD.We also discussed CD by reviewing different literatures on its diagnosis,treatment and outcome.Conclusion CD is an atypical lymphoproliferative disorder and a heterogeneous entity that can be either localized or systematic.The etiology and pathogenesis of this entity is still unclear.The imaging findings though are not specific,still can help make differential diagnosis.The hyaline vascular type frequently appears as a benign isolated mediastinal or rarely retroperitoneal mass,which does not recur after curative surgical excision.     

SURGICAL TREATMENT OF TETRALOGY OF FALLOT IN CHILDREN: A REPORT OF NO SURGICAL DEATH IN 115 CONSECUTIVE CASES

ffeSUIn Objeetif Un groupe de chrurghns a fait la correction totale pour la tdtratogh de Fallot sur115 meW cootutimnt sens un cos de mot ortratOire. As then t article est une invotoption sur les fac-teurs d' andlioration du theltat Oviratoire. -- Parmi 115 enfants dont I' dge etait de 9 mOs d 13ans(4, 6 f 2, 7 ans), 47, 8% des enfantS etalent mOns de 3 ans. Les nzaffrvtions orha mpient I'atrdrie du tronc et de la branChe uniIathele de l' art8re PUhaonaire chez 4 mahaes; les mmunicotions…     

ANALYSIS OF EFFICACY IN TREATMENT OF LOW-RISK WELL-DIFFERENTIATED THYROID CANCER WITHOUT CERVICAL LYMPH NODE INVOLVEMENT： 42 CASES REPORT

Objective To assess the more appropriate surgical treatment for low-risk group differentiated thyroid cancer. Methods A total of 42 low-risk patients with DTC, according to the AMES system （ male, n = 6; female, n = 36）, were chosen for total thyroidectomy or subtotal thyroidectomy with center compartment lymphadectomy. Results Nineteen patients had cervical lymph node involvement. Two patients had recurrent nerve injured. One patient had hypoparathyroidism. There were no mortality or local lymph recurrent up to present. Conclusion Total thyroidectomy or subtotal thyroidectomy with prophylactic center compartment lymphadectomy is an appropriate approach for the treatment of low-risk group differentiated thyroed cancer, to prevent recurrent and improve life quality.     

THYMIC CARCINOMA （REPORT OF 14 CASES）

This paper reports of 14 cases of thymic carcinoma. Most of them with symptoms of chest pain, chest stuffy and discomfort, but without combined with extrathoracic syndrome, The tumors always were large in size and frequently invaded adjacent organs, hence with low resection rate. In this series, complete resection of tumor only 2 cases, partial resection in 7 cases, exploratory thoracotomy in 5 cases. Thymic carcinoma was an extremely malignant tumor with extensive invasion intrathoracally and early metastasis extrathoracally. The common sites of metastasis were bone, liver,lung and extrathoracic lymph nodes. Adjurant therapy postoperatively was given to all patienxs. Follow up of 1-8 years showed 10 cases death,of which 5 coses diod within the first year after surgery,3 eases within the second year. Four patients were still alive so far, in which 3 patients were within 1.5 years postoperativaly. Pathological studies revealed 9 cases of squamous epithelial cell thymic carcinoma ,3 of lymphoepithelioma-like thymic carcinoma and 2 of small cell undifferentiate thymic carcinoma.     

MANAGEMENT OF AE-CB/COPD： A SURVEY OF RESPIRATORY PHYSICIANS IN SOME REGIONS OF CHINA

Objective To investigate the bacteria spectrum isolated from AE-CB/ COPD and the manner of management of AE-CB/COPD in respiratory or internal medicine department in some regions of China. Methods Respiratory physicians received questionnaire at randomization just after they managed a patient presenting to outpatient department with AE-CB/ COPD, on general conditions and symptoms of patients, type of examinations, diagnosis, type of antibiotics used and mode of administration. Results of sputum bacteria culture were followed up. Results Amang the1583 AE-CB/COPD, 63. 04% were male and 35.19% were female. 54.6% of them were older than 60 years. 81.87% of the patients produced sputum. Sputum bacteria culture, chest X-ray and chest CT were carried out to 21.3%, 66. 3% and 11. 1% patients, respectively. 355 strains were isolated from patients whose sputum bacteria culture was positive. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella ca- tarrhalis were the three most isolates. 84. 7% of the 1583 AE-CB/COPD received 1692 times of antibiotic prescribing. The most frequently prescribed antibiotic were B-lactams （51.36% of all antibiotic prescribing）, macrolides （14. 01% ） and quinolones （31.03%）. Much more macrolides were prescribed in the area where mare patients pay the medicines at his own expense than those in the area where more patients share public health service. Conclusion In China, respiratory physicians can reasonably select antibiotics to manage acute exacerbation of chronic bronchitis/ chronic obstructive pulmonary disease in pulmonary outpatient department. Sputum culture is done in part of the patients, but susceptibility tests are missing. One issue revealed by the survey is that the list of prescribing medications laid down by government have great influence on antibiotic use.     

ANALGESIC EFFECT OF PRESSURE ON AURICULOACUPOINTS FOR POSTOPERATIVE PAIN IN 102 CASES

In recent years,acupuncture analgesiais widely used clinically,whereas the use ofauriculoacupuncture in this respect is rarelyreported.During Jan.1986-April 1990,theauthors adopted Auriculoacupoint Pressurefor its analgesic effect in 102 cases ofpostoperative pain with satisfactory resultsas reported in the following.     

婴幼儿急性肠套迭手术治疗238例分析

２３８例结肠注气整复失败而手术治疗的急性婴幼儿肠套迭中，肠坏死７１例（２９．８４％），复套迭１１２例（４７．０６％），发现器质性病变１１例（４．６２％），结肠注气整复致肠穿孔６例（２．５２％），发病至就诊时间在４８ｈ以上７１例（２９．８３％）。认为本病结肠注气整复失败原因主要为：①复套迭，②肠坏死，③就诊时间过晚。强调要正确掌握空气整复适应及禁忌症，防止肠穿孔。并就本病结肠注气整复和手术的有关问题进行讨论。     

小儿急性肠套叠手术治疗体会(附66例临床分析)

目的：探讨肠套叠的诊断和治疗。方法：对352例肠套叠行空气灌肠整复失败改为手术治疗的66例进行回顾性研究。结果：术中3例未发现肠套叠，但有回肠压迫性水肿。徒手复位42例，肠切除13例，必须切除阑尾、憩室各3例，死亡2例。结论：小儿肠套叠，一般情况好，在X线荧屏下，可适当延长注气时间，增加注气压力。对中毒严重、肠生机不良者，采用肠切除术。     

小儿不典型肠套迭早期诊断(附35例分析)

本文报告自1975年元月至1986年12月住院的小儿不典型肠套迭33例,提出在早期诊断中应当注意的诸如呕吐、腹痛和腹部肿块、肠鸣音亢进等临床表现。讨论了造成小儿肠套选临床表现不典型的原因,提出了获得早期诊断应注意的问题,避免误诊。就诊断标准等问题提出了新的见解.     

丹参注射液对肠套叠手术患儿血清一氧化氮水平的影响

目的观察丹参注射液对肠套叠患儿术后血清一氧化氮(NO)水平的影响,探讨其保护机制及临床意义。方法将180例急性肠套叠手术患儿随机分为丹参治疗组与常规治疗组,丹参治疗组患儿在常规治疗的基础上,给予丹参注射液静脉滴注,常规治疗组应用常规治疗方案。二组患儿于不同时段分别测定血清NO水平,进行统计分析,并比较受累阑尾损伤程度。结果丹参治疗组、常规治疗组手术前血清NO水平差异无统计学意义(P>0.05),手术后丹参治疗组血清NO水平与常规治疗组比较差异有统计学意义(P<0.01);丹参治疗组阑尾组织细胞损伤程度较常规治疗组明显减轻。结论丹参注射液能够抑制肠套叠患儿体内NO的生成,对肠缺血再灌注损伤有明显的保护作用。     

158例小儿急性肠套叠临床诊治分析

小儿急性肠套叠是常见的急腹症,如果能早期诊断,及时治疗,效果良好。本文就早期诊断,提高灌肠复位率,降低手术率等进行总结分析。     

儿童感染相关性噬血细胞综合征37例临床分析

目的分析儿童感染相关性噬血细胞综合征的临床特点及诊治情况。方法回顾性分析37例感染相关性噬血细胞综合征病儿的临床及实验室资料。结果EB病毒感染者23例（62．2％），CMV感染者4例（10．8％），细菌感染者8例（21．6％），病原不明者2例（5．4％）；本组病例临床主要特点为持续高热（100．0％），肝大（83．3％），脾大（91．7％）；外周血白细胞计数减少（76．2％），血小板减少（91．7％），血红蛋白减少（77．8％）；纤维蛋白原低下（66．7％）；肝功能异常（51．2％），血清三酰甘油升高（100．0％），铁蛋白升高（83．3％）；骨髓涂片找到噬血细胞（100．0％）。VP-16、环孢素A（CsA）、糖皮质激素及静脉注射免疫球蛋白（IVIG）联合治疗33例，糖皮质激素及IVIG联合治疗2例，其中治疗有效30例，死亡5例。确诊后放弃治疗2例。结论典型的儿童感染相关性噬血细胞综合征临床以持续高热、肝脾大为主要表现，实验室检查以白细胞计数、血红蛋白及血小板中两系或三系减少、低纤维蛋白血症、高三酰甘油血症、肝功能异常及血清铁蛋白升高，骨髓找到噬血细胞为主要特点。早期诊断、早期治疗能挽救该类病儿的生命。     

小儿气管支气管异物361例临床分析

自1986年6月至1990年6月收治小儿气管、支气管异物共361例,占同期住院病人的2.5%。男女之比为1.56:(?)1。年龄最小者7个月,最大者12岁,3岁以下者占88.1%。绝大多数为植物性异物,以花生米最多。异物多发生在8、11、12月份,8月份为高峰期。本文讨论了异物发生的原因、并发症及其治疗中的一些问题。     

重症胰腺炎手术并发症7例临床分析

报道重症胰腺炎术后并发症7例,对其发生原因、预防及处理进行了讨论。认为,重症胰腺炎术中、术后处理得当,可减少并发症,使手术取得满意效果。本院1985年12月～1990年8月,手术治疗重症胰腺炎19例,死亡3例,病死率15.8％,术后有7例出现一种或两种并发症,发生率为36.8％。