Postchemotherapy retroperitoneal residual mass in infantile yolk sac tumor

BACKGROUND: Persistent postchemotherapy retroperitoneal residual mass with normalization of alpha-fetoprotein (AFP) in infantile yolk sac tumor is rare. METHODS/RESULTS: A 38-month-old boy with recurrent yolk sac tumor was treated with cisplatin-based combination chemotherapy. After chemotherapy, the retroperitoneal lymph node metastasis, 7 x 6 cm in size, decreased to 2 x 2 cm. Serum AFP levels returned to normal. The retroperitoneal residual mass was resected and histologically showed complete necrosis without viable cancer cells. CONCLUSION: The patient has remained free of disease for 36 months after operation.     

不同文化层次孕妇对儿童早期教育认知现状的调查分析

目的了解沧州市区不同文化层次孕妇对0~3岁儿童早期教育的认知现况。方法采用随机整群抽样的方法,对沧州市5个社区孕妇进行调查。结果孕妇对儿童早教知识知晓度与文化层次有关;学历越高的孕妇对儿童早教知识的知晓程度较高,知识来源主要为专业培训和书籍媒体;学历越低者对儿童早教知识来源途径较少。结论不同文化层次的孕妇对儿童早期教育的认知度不同,社区卫生服务应针对不同文化层次的孕妇开展儿童早期教育知识的宣传,促进儿童早期教育的发展。     

Lower Urinary Tract Symptoms and Video‐Urodynamic Characteristics of Women with Clinically Unsuspected Bladder Outlet Obstruction

Objective: To analyze the lower urinary tract symptoms (LUTS) and video‐urodynamic characteristics of women with clinically unsuspected bladder outlet obstruction (BOO). Methods: From 1997 to 2010, a total of 1605 women with bothersome LUTS received video‐urodynamic study in our unit. We reviewed the charts of 212 women diagnosed with BOO based on video‐urodynamic criteria and 264 women without abnormal findings. LUTS and urodynamic parameters were compared between obstructed and unobstructed cases and among the BOO subgroups. Results: The mean ages of the BOO (58.2 years) and control groups (58.8 years) were similar. The mean values of detrusor pressure at maximum urinary flow rate (P_detQ_max)/maximum flow rate (Q_max) of the BOO and control groups were 51.83 cm H₂O/10.22 mL/s versus 18.81 cm H₂O/20.52 mL/s. In the BOO group, cinefluoroscopy revealed dysfunctional voiding in 168 patients (79.2%), urethral stricture in 17 (8.0%), and bladder neck dysfunction in 27 (12.7%). Patients with dysfunctional voiding had significantly lower urethral resistance compared with the other two BOO subgroups. Combined lower urinary tract symptoms were present most often in all BOO patients (69.3%), followed by isolated storage symptoms (30.2%) and isolated voiding symptoms (0.5%). Seventy‐seven patients (37.3%) had dysuria and 79 patients (36.3%) had frequency as their main symptom. Conclusion: Women with BOO usually have nonspecific LUTS. Dysfunctional voiding was the most common form among women with clinically unsuspected BOO, but the degree of obstruction was less severe than with primary bladder neck obstruction and urethral stricture.     

Review article: Endothelial progenitor cells in renal disease

This brief overview is intended to provide basic information about endothelial progenitors, their definition and consensus markers used for their detection, describe the pathways of their mobilization and homing and highlight the mechanisms and manifestations of their incompetence that occurs in some chronic kidney diseases. Discussion is geared towards the potential role of endothelial progenitor cells in organ regeneration, in particular, in kidney regeneration. The concept we attempted to promote attributes to the incompetence of endothelial progenitor cells in failed regeneration and ensuing progression of chronic kidney disease. This field of inquiry remains insufficiently explored, especially in renal diseases. Promising areas for future exploration are emphasized.     

Difficult Urination Does Not Affect the Successful Outcome after 100U OnabotulinumtoxinA Intravesical Injection in Patients with Idiopathic Detrusor Overactivity

Objectives: Intravesical injection of onabotulinumtoxinA (i.e. Botox) provides effective treatment for overactive bladder. However, treatment‐related adverse events (AEs) remain problems. This study investigated the effect of AEs after onabotulinumtoxinA injection on the success rate for idiopathic detrusor overactivity (IDO). Methods: A total of 174 patients who received the first single intravesical onabotulinumtoxinA 100U injection for refractory IDO were included. The onabotulinumtoxinA related AEs including acute urinary retention (AUR), large postvoid residual (PVR, ≥150 mL), difficult urination, urinary tract infection, gross hematuria and general weakness were recorded. The success rate was determined based on patient perception of bladder condition improved by two scales. The short‐term (3 months) and long‐term (up to 24 months) success rates were analyzed according to the occurrence of these AEs. Results: A successful outcome was reported by 138 (79.3%) patients at 3 months. AUR occurred in 12 (6.9%) patients, large PVR developed in 81 (46.6%) and 73 (42%) needed straining to void. Gross hematuria occurred in 17 (9.8%) patients, urinary tract infection developed in 27 (15.5%) and general weakness was noted in 6 (3.4%). The occurrence of AUR did not affect the therapeutic results. Patients having large PVR and difficult urination had a significantly higher success rate at 3 months. Long‐term success rates up to 24 months showed no significant difference between patients with and without AEs. Conclusions: AEs after intravesical 100U onabotulinumtoxinA for IDO were frequently encountered. However, the occurrence of AUR, large PVR or difficult urination did not affect the final therapeutic outcome.     

Diagnosis and Management of Bladder Outlet Obstruction in Women

Bladder outlet obstruction (BOO) should be considered when a woman complains of voiding difficulty, abdominal straining to void, or refractory storage symptoms. Diagnosis of female BOO is not straightforward and usually requires invasive (video)urodyanmic study. A diagnostic algorithm is recommended for making optimal diagnosis. Female BOO can be classified as having anatomical and functional origins, and each contains several sub‐classifications. Literatures published between 1988 and 2013 were reviewed and summarized for the diagnosis and therapy in each subtype of female BOO.     

重症监护室泛耐药鲍曼不动杆菌感染暴发流行调查与控制对策

目的 研究重症监护室泛耐药鲍曼不动杆菌(PDR-AB)感染危险因素及控制措施.方法 采用现场采样检验和药敏试验方法,对某医院呼吸重症监护室(RICU) 一起下呼吸道泛耐药鲍曼不动杆菌杆菌暴发流行事件进行调查.结果 该医院重症监护室2010年8月24日～12月13日期间连续发生了6例下呼吸道医院感染病例.经药敏试验证明,所检出的鲍曼不动杆菌对临床常用22种抗菌药物中的20余种耐药,且耐药谱相同或相近.经对室内空气及环境表面采样检验,在床具栏杆、呼吸机面板、护士办公室电话机表面等均检出(PDR-AB).结论 此次泛耐药鲍曼不动杆菌感染来源于RICU环境污染,呈广泛耐药性,经医护人员手传播,经过积极治疗病人,采用消毒隔离,强化环境清洁与消毒措施,有效控制了感染流行.     

SWEET'S SYNDROME: CLINICOPATHOLOGIC STUDY OF ELEVEN CASES

Background. The clinicopathologic manifestations of Sweet's syndrome associated with malignancy have been rarely studied in a large series. Methods. We describe the clinical features of Sweet's syndrome in 11 patients seen during the past 12 years. Histopathologic findings of these patients are discussed. The clinicopathologic manifestations of 249 cases of Sweet's syndrome reported in the literature were reviewed. Results. The clinicopathologic manifestations of Sweet's syndrome associated with hematologic disorders (HSS) were more severe and characterized by bullous pyoderma with more pronounced epidermal changes and ulceration, anemia, giant platelets and abnormal platelet counts. Approximately 40% of the Sweet's syndrome reported in the literature were associated with hematologic malignancy, and the other 7% of patients had solid tumors. Conclusions. Sweet's syndrome can be classified into three types: (1) association with hematologic disorders (HSS); (2) association with solid tumors (SSS); and (3) idiopathic or associated with various other disorders (ISS).