3升塑料袋用于腹腔扩容治疗腹内高压症

【摘要】〓目的〓探讨3升塑料袋腹腔扩容在腹腔高压症中的应用。方法〓18例腹腔高压症的患者,包括急性重症胰腺炎、肠系膜血管栓塞、消化道穿孔、肠扭转及腹部外伤的危重症患者。所有患者均性剖腹探查手术及采用3升塑料袋腹腔扩容、减压,4~8天患者平稳后二次手术。 结果〓18例患者中死亡3例,其中急性重症胰腺炎1例,全小肠扭转1例,消化道穿孔1例,另15例痊愈出院。术后并发症包括2例腹腔脓肿、1例切口疝、1例出现营养吸收不良。 结论〓3升塑料袋腹腔扩容在腹腔高压症中的应用安全、经济、疗效满意。     

老年脑卒中偏瘫患者的平衡训练

对１０９例老年脑卒中偏瘫患者平衡训练进行观察，发现患者经训练后，各项能力都有明显改善。与老年前期组相比无差别。训练对恢复运动及日常生活活动很有价值。观察还表明，平衡能力由高到低呈规律性变化，对指导平衡训练及判断预后有参考作用。     

Correlation Between Fluid–Fluid Levels on Initial MRI and the Response to Chemotherapy in Stage IIB Osteosarcoma

Background

The presence of fluid–fluid levels (FFLs) on osteosarcoma magnetic resonance imaging (MRI) is underestimated as a nonspecific finding; however, we hypothesized that FFL in conventional osteosarcoma may be indicative of chemoresistance.

Methods

In 567 stage IIB osteosarcoma patients, we evaluated the following: the incidence of FFL and their correlation with other clinicopathological variables; tumor volume change after chemotherapy and survival according to the presence of FFL; and the relationship between survival and the extent of FFL.

Results

One hundred eight (19 %) tumors showed FFL on initial MRI. FFL were correlated with proximal humeral location (P = 0.017), osteolytic on plain radiographs (P < 0.001), tumor enlargement after chemotherapy (P < 0.001), and poor histological response (P = 0.005). Large tumor (P < 0.01), proximal tumor location (P = 0.01), and presence of FFL (P < 0.01) were independent predictors of poor survival. Compared to the extensive FFL (more than one third of the tumor), small foci of FFL (less than one third of the tumor) showed a high tendency for tumor enlargement after chemotherapy (P < 0.001), poor histologic response (P = 0.001), and worse survival (P < 0.001).

Conclusions

FFL on initial MRI could predict tumor progression after chemotherapy. Notably, tumors with small foci of FFL (less than one third of the tumor) have a high propensity for poor outcome. Patients with this finding should be considered for risk-adapted therapy.     

人类疱疹病毒6型对血液病患者巨噬细胞集落刺激因子表达的 …

探讨人类疱疹病毒６型与血液病患者巨噬细胞集落刺激因子异常表达的关系。方法：以卵白素－和物素复合物免疫酶２标和逆转录－聚合酶链反应方法检测３０例血液病患者骨髓单个核细胞体外感染ＨＨＶ－６后Ｍ－ＣＳＦｍＲＮＡ的表达。     

Prostate cancer detected after Holmium laser enucleation of prostate (HoLEP): significance of transrectal ultrasonography

Purpose

To identify predictors of incidental prostate cancer following Holmium laser enucleation of the prostate (HoLEP).

Methods

We retrospectively analyzed 458 consecutive patients who underwent HoLEP. Patients were classified into two groups: patients who received prostate biopsy prior to HoLEP (biopsy group, n = 174) and patients who did not (non-biopsy group, n = 284). The two groups were compared. Logistic regression analysis was performed to determine the predictive factors.

Results

A total of 27 patients (5.9 %) were incidentally diagnosed with prostate cancer. The incidence of prostate cancer was not significantly different between the two groups (biopsy group vs. non-biopsy group: 6.9 vs. 5.3 %, p = 0.48). Using multivariate analysis, a hypoechoic lesion identified by transrectal ultrasonography (TRUS) was the only predictor of incidental prostate cancer (odds ratio 2.829; 95 % confidence interval 1.061–7.539; p = 0.038). In the biopsy group, there were no significant differences in baseline characteristics including prostate size, prostate-specific antigen (PSA), PSA density, digital rectal examination (DRE) findings, and TRUS findings, between patients with and without prostate cancer. However, in the non-biopsy group, a hypoechoic lesion was found more frequently in patients with prostate cancer (prostate cancer vs. benign prostatic hyperplasia: 20.0 vs. 3.3 %, p = 0.02).

Conclusions

Prior negative prostate biopsy does not rule out the possibility of prostate cancer after HoLEP. The presence of a hypoechoic lesion on TRUS might be helpful to predict incidental prostate cancer after HoLEP in patients with normal PSA and negative DRE. Prostate biopsy prior to HoLEP should be considered in these patients.