囊性肾癌11例临床分析

目的 提高对囊性肾癌的认识.方法 回顾性分析我院2001年1月至2007年1月收治的235例肾癌中11例囊性肾细胞癌病人的临床资料.结果 11例病人中8例行肾癌根治术,3例行肾部分切除术;多房囊性肾癌8例,单房囊性肾癌3例;透明细胞癌9例,嫌色细胞癌2例.11例均获随访,随访时间3～61个月,平均27.9个月,无瘤存活10例.结论 囊性肾癌采用肾癌根治或肾部分切除术治疗效果满意,预后佳.     

乳头状肾细胞癌的临床诊治

目的 提高对乳头状肾细胞癌的诊治水平.方法 回顾性分析我院2002年1月～2007年1月205例肾癌患者中15例(7.3%)乳头状肾细胞癌患者的病历资料,分析其临床表现、病理学及影像学特征、临床治疗及预后情况.结果 15例患者中11例行肾癌根治术,4例行肾部分切除术.15例均获随访,随访时间10～70个月,除2例患者分别于术后15、21个月死于转移外,其余患者均无瘤生存.结论 乳头状肾细胞癌是一种比较少见的肾细胞癌,其确诊有赖于病理检查,治疗仍以手术为主,预后较好.     

囊性肾细胞癌的生物学特性、临床特点及预后分析

目的对囊性肾细胞癌的生物学行为、临床诊断、治疗选择及预后进行分析,以提高对这一少见类型肾癌的认识。方法回顾性分析我院2000年至2005年间9例囊性肾细胞痛患者的临床资料,研究其临床特点、影像学特征、病理学特性、免疫组织化学及手术进程等,随访其预后；并与同期207例其他肾细胞癌患者的肿瘤分期、分级及预后等进行比较。结果囊性肾细胞癌9例,占同期肾细胞癌的4．2%(9/216例),其中多房囊性肾癌7例、单房囊性肾癌2例。肿瘤核分级Ⅰ级6例(66．7%)、Ⅱ级3例(33．3%)；肿瘤分期T1期8例(88．9%)、T2期1例(11．1%),均低于同期非囊性肾细胞癌(P=0．000 1和0．045)。临床偶然B超检查发现7例(77．8%),CT检查示多房性囊肿7例(77．8%)、包膜钙化2例(22．2%)、囊内不均匀强化或见囊实相间改变5例(55．6%),术前诊断率为66．7%(6/9例)。本组6例行根治性肾切除术、3例行肾切除术,平均随访28个月,疾病特异生存率为88．9%(8/9例),高于同期非囊性肾癌的71．0%(147/207例)。结论囊性肾细胞癌的分期、分级较传统肾癌更低,并有其特殊的临床、病理及影像学特征,手术治疗效果满意。     

囊性肾癌的诊断和治疗

目的:提高对囊性肾癌的认识。方法:对1997~2006年收治的8例囊性肾癌的诊断、治疗、预后等资料进行回顾性分析。结果:术前超声诊断囊性肾癌5例,CT诊断囊性肾癌6例,术中冰冻切片提示恶性肿瘤2例;7例行根治性肾切除术,1例行肾部分切除术;术后病理均为囊性肾透明细胞癌。8例获随访,7例生存至今。结论:囊性肾癌的诊断主要依靠影像学及病理学检查,确诊后应行根治性肾切除术或部分肾切除术。     

囊性肾细胞癌的诊治分析

目的:探讨囊性肾细胞癌的临床特点、诊断及治疗方法,提高囊性肾细胞癌的诊治水平。方法:回顾性分析60例囊性肾细胞癌患者的临床资料及随访结果。结果:44例行根治性肾切除术,15例行肾部分切除术,1例行单纯性肾切除术。术后病理结果:多房囊性肾细胞癌18例,囊性坏死肾细胞癌25例,单房囊性肾细胞癌11例,单纯囊肿恶性变6例。56例获随访,平均随访52个月(6~100个月),1例尿毒症患者术后15个月死于肾衰竭;余患者随访期内均未见局部复发或远处转移。结论:囊性肾细胞癌无特征性临床表现,诊断主要依靠影像学检查,术前诊断困难者可术中快速冰冻病理检查。囊性肾细胞癌预后较好,治疗应争取行保留肾单位手术。     

囊性肾细胞癌的诊治分析

目的:分析并探讨囊性肾细胞癌的临床特点、诊断及治疗方法,提高囊性肾细胞癌的诊治水平。 方法:回顾性分析60例囊性肾细胞癌患者的临床资料及随访结果。 结果:44例行根治性肾切除术,15例行肾部分切除术,1例行单纯性肾切除术。术后病理结果:多房囊性肾细胞癌18例,囊性坏死肾细胞癌25例,单房囊性肾细胞癌11例,单纯囊肿恶性变6例。56例获随访,平均随访52个月(6~100个月) ,1例尿毒症患者术后15个月死于肾衰竭;余患者随访期内均未见局部复发或远处转移。结论:囊性肾细胞癌无特征性临床表现,诊断主要依靠影像学检查,术前诊断困难者可术中快速冰冻病理检查。囊性肾细胞癌预后较好,治疗应争取行保留肾单位手术。     

保留肾单位手术治疗肾癌的临床观察

目的:探讨保留肾单位手术治疗肾癌的安全性和疗效。方法:回顾性分析21例行保留肾单位手术的肾癌患者临床资料,其中双侧肾癌2例,孤立肾肾癌2例,对侧肾有病变或潜在功能受损的肾癌8例,对侧肾正常肾癌9例,肿瘤平均直径3.3cm。21例中13例行肿瘤剜除术,8例行肾部分切除术。结果:术后组织病理学结果示肾透明细胞癌16例,颗粒细胞癌3例,混合性细胞癌2例。术后20例(95%)获随访,随访时间6个月～140个月,平均随访56个月。5a、10a生存率分别为90%、81%。4例术后出现局部复发和远处转移。结论:保留肾单位手术治疗肾细胞癌安全有效,尤其适于局限性低分期小肾癌患者。     

不同亚型的囊性肾癌诊疗与预后分析

?目的:探讨不同亚型的囊性肾癌的诊疗及预后情况。方法:回顾性分析75例囊性肾癌患者的临床资料。患者术前影像学检查:56例考虑恶性病变,13例考虑单纯性肾囊肿,6例考虑为多房性肾囊肿。47例行根治性肾切除术,其中开放手术20例,腹腔镜手术27例;保留肾单位手术14例,其中开放手术9例,腹腔镜手术5例;后腹腔镜下肾囊肿去顶减压术13例 ,其中2例术中冰冻病理检查提示恶性,同期行根治性肾切除术,9例术后2～3周二期行根治性肾切除术,2例密切随访;1例行保留肾单位手术,术中冰冻病理检查提示恶性病变,同期行根治性肾切除术。结果:75例术后病理报告均为囊性肾癌,其中肾细胞癌囊性变38例,多房囊性肾癌16例,单房囊性肾癌（囊腺癌）8例,肾囊肿恶变13例。随访25～147个月,平均63个月,未见肿瘤复发和转移。结论:囊性肾癌的诊疗及预后需根据不同的亚型分析,保留肾单位手术可作为囊性肾癌的一种可选择的治疗方式。     

囊性肾癌的诊断和治疗12例报道并文献复习

目的 旨在提高对囊性肾癌的认识.方法 回顾性分析12例囊性肾癌患者的临床特点、影像学表现、手术方式的选择、病理特点及随访情况. 结果 11例行肾癌根治术,1例行肾肿瘤剜除术.病理分期T1期7例,T2期4例,T3期1例.11例术后随访平均28个月(8～60个月),无瘤存活10例. 结论 囊性肾癌是一种少见的临床病理亚型,CT表现相对有特征性,对可疑囊性肾癌患者,术中须行病理检查,确诊后,肾癌根治术治疗效果满意,预后佳.     

囊性肾细胞癌15例临床分析

目的分析囊性肾细胞癌（CRCC）的临床特征,提高对CRCC的诊疗水平。方法分析15例CRCC患者的临床资料。结果 CRCC患者的腹部平片、IVP表现与肾癌或其他肾囊性改变相似。15例患者测得平扫CT值为12～46Hu,增强CT值为20～110Hu。表现为囊壁不均匀增厚。5例CT平扫见点状、斑点状钙化,钙化灶外可见多少不等的软组织成分。7例CRCC患者行磁共振检查,T1加权像呈低信号或混杂信号,T2加权像呈高信号,增强后不规则强化。15例患者均行手术治疗,其中肾癌根治术12例,肾部分切除术3例。术中见多房囊性肾癌11例,单房囊性肾癌4例。病理检查示透明细胞癌13例,嫌色细胞癌2例。15例平均随访27.9个月,无瘤存活13例。结论 CRCC临床表现无特异性,术前B超、CT检查结合MRI可以提供诊断依据。CRCC采用肾癌根治术或肾部分切除术治疗,效果满意,预后佳。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.