重组生长激素对术后营养支持患者人体组分和肌肉功能的影响

用前瞻、双盲方法研究了营养支持和生长激素对术后患者人体组分和肌肉功能的变化。所有患者提供等氮等热卡肠外营养液。研究组术后１～７ｄ给生长激素。人体组分研究表明，对照组体重丢失３．３ｋｇ时，瘦肉组织丢失２．８±１．４６ｋｇ，脂肪丢失０．４９±１．３ｋｇ，而研究组患者体重丢失１．０ｋｇ，主要为脂肪，总体水和无脂细胞群基本不变。握力测定发现对照组手术后握力强度下降（Ｐ＜０．０１），给生长激素后握力强度基本不变，手术前后对比无统计学差异。研究结果表明，营养支持及重组生长激素能减少术后患者的瘦肉组织和肌肉功能损失。     

Spermatic vein embolization with hot contrast material: fertility results

Spermatic venography with hot contrast material embolization was undertaken in 81 patients with varicoceles and infertility. Long-term follow-up information was available in 91% of the patients, and there was an overall conception rate of 40.5%. Embolization with hot contrast material was easily performed without special embolization devices and proved to be a safe and effective technique.     

Cognitive and adaptive outcome in low-grade pediatric cerebellar astrocytomas： evidence of diminished cognitive and adaptive functioning in National Collaborative Research Studies （CCG 9891/POG 9130）.

PURPOSE： Clinicians often assume that children with posterior fossa tumors are at minimal risk for cognitive or adaptive deficits ff they do not undergo cranial irradiation. However, small case series have called that assumption into question, and have also suggested that nonirradiated cerebellar tumors can cause location-specific cognitive and adaptive impairment. This study （1） assessed whether resected but not irradiated pediatric cerebellar tumors are associated with cognitive and adaptive functioning deficits, and （2） examined the effect of tumor location and medical complications on cognitive and adaptive functioning. PATIENTS AND METHODS： The sample was composed of 103 children aged 3 to 18 years with low-grade cerebellar astroeytomas, who underwent only surgical treatment as part of Children＇s Cancer Group protocol 9891 or Pediatric Oncology Group protocol 9130. The sample was divided into three groups based on primary tumor location： vermis, left hemisphere, or right hemisphere. Data were collected prospectively on intelligence, academic achievement, adaptive skills, behavioral functioning, and pre-, peri-, and postsurgical medical complications. RESULTS： The sample as a whole displayed an elevated risk for cognitive and adaptive impairment that was not associated consistently with medical complications. Within this group of children with cerebellar tumors, tumor location had little effect on cognitive, adaptive, or medical outcome. CONCLUSION： We did not replicate previous findings of location-specific effects on cognitive or adaptive outcome. However, the elevated risk of deficits in this population runs contrary to clinical lore, and suggests that clinicians should attend to the functional outcomes of children who undergo only surgical treatment for cerebellar tumors.