结肠粘膜重建尿道的实验研究

目的：探讨结肠粘膜重建尿道的可能性。方法：选择6条雌性杂种成年犬，在全麻下切开尿道，剥离全段尿道粘膜，取相等长度的结肠粘膜替代尿道粘膜，12周后将犬处死，取其尿道作病理检查。结果：犬尿道病理组织学检查示移植于尿道的结肠粘膜全部成活，大部分腺上皮已转变为移行上皮。结论：应用结肠粘膜重建尿道是一种新的方法，这种技术可应用于包皮或膀胱及颊粘膜不适合时的尿道重建。     

急性百草枯中毒19例报告

百草枯,又名克芜踪、对草快,化学名称11—二甲基—4.4—联吡啶,是触杀型、灭生性除草剂。急性中毒时常发生肺、肝、肾、心等多器官损害,病死率极高。现将我院1990年10月～1992年2月收治的19例急性中毒报告如下。 1 一般资料本组男5例、女14例,男女之比1:2.8,年龄2～57岁。轻度中毒5例,重度中毒14例。经口中毒17例,其中口服剂量<30ml 8例,死亡1例;30～100ml 5例,死亡3例;>100ml 4例,死亡4例。     

前列腺导管腺癌临床病理和诊治特点分析

Objective To discuss the pathological and clinical features, diagnosis and treatment of prostatic duct adenocareinoma. Methods The clinical data of nine cases of prostatic duct adeno-carcinoma were retrospectively analyzed, with the average age of 76 (59-106) years. Six cases were presented with dysuresia and/or nocturia, and two of them had the painless gross hematuria. Two pa-tients presented painless gross hematuria as the first symptom. One case was detected the elevated ser-um PSA in a routine healthy examination. Radical prostatectomy (RP) was performed in 1 case;RP and bilateral orchidectomy and external beam radiotherapy (EBRT) were performed in 1 case;5 cases underwent transurethral resection of the prostate (TURP) combined with photoselective vaporization of the prostate (PVP) by green laser and bilateral orchidectomy;1 case underwent TURP combined with PVP;1 case underwent bilateral orchidectomy combined with EBRT. Eight cases took flutamide for 3-45 months. All patients were followed-up according to the scheduled time. Results The op-erations were successfully performed in all 9 patients. The papillary or cauliflower-like tumors infiltra-ted colli culus seminalis and prostate duct nearby. The glands were coated with tall pseudostratified columnar cells. The nuclei were large, dark stained with more frequent mitoses. The positive rates of immunolabelling antibody PSA, AR, PAP were found to be 89%(8/9), 100%(5/5), 100%(5/5) re-spectively. The distribution of Gleason score was 6-7(3 cases), and≥8(6 cases), and a coexisting acinar carcinoma component was identified in 5 cases of the group. Nine cases had a mean follow up for 20(3-48) months. Five cases have developed biochemical recurrence, of whom 3 died of bone metas-tasis and multiple organ failure, and 1 developed lung and bone metastasis. Three cases remained alive without recurrence. The remaining 1 case survives during the follow-up survey for 6 months until now, without examinations due to the old age. Conclusions Duct adenocarcinoma of the prostate presents the low incidence and lacks of typical symptoms in the early stage. Diagnosis was confirmed mainly on the basis of pathology. The tumors tend to have a more advanced stage and a very short term survival rate. The treatment options and management are similar to that of high-grade adenocar-cinoma of the prostate;meanwhile, close follow-up survey should be performed.     

EPCA-2:前列腺癌高特异性血清肿瘤标志物

前列腺特异抗原(PSA)的发现对于前列腺癌的早期诊断具有里程碑意义。PSA筛选的广泛应用使转移阶段的前列腺癌、早期浸润前列腺癌获得了有效的治疗,并降低了疾病的死亡率。但前列腺其他疾患(如BPH、前列腺炎等)亦可有PSA升高,使得PSA的特异性稍显不足。蛋白组学的发展推动了高特异性新肿瘤标志物的发展。细胞核改变是癌症的显著标志。研究发现,不仅人类BPH和前列腺癌的细胞核结构蛋白组分不同,而且大鼠正常前列腺、前列腺癌和转基因小鼠前列腺癌模型的细胞核蛋白组分亦差别明显。作者在前列腺癌核结构蛋白组学研究中发现了两个独立的…     

家用心电远程监护系统

本文所介绍的“家用心电远程监护系统”是以把心电监护的场所从医院病房移至家中为目的而研制的一种新系统。不但病人能承受使用它的经济负担，同时也能节省医院的医疗资源，从而能使更多需要监护的心脏病人能够得到有效的护理     

膀胱无功能恶性嗜铬细胞瘤一例报告

患者,女,52岁。1990年3月B超检查时发现膀胱后壁有一肿块入院。患者曾有一次无痛性肉眼血尿,排尿时无任何不适。入院时尿常规阴性,血压17.2/11.3kPa。膀胱镜检:膀胱后壁、输尿管间嵴上方有一球形肿块1.5×1.5cm,其表面粘膜光滑,血管纹理清晰。B超示膀胱后壁有1.2×0.8cm肿块,     

巨大肾动脉瘤一例报告

患者,女,54岁,右腰部酸胀不适10d于2004年3月4日入院.无血尿,无尿路刺激征.查体：血压160/95 mmHg,右上腹扪及直径10 cm肿块,囊性,边缘光滑,右背部可闻及吹风样血管杂音.     

膀胱全切除输尿管皮肤造瘘治疗高龄T3期膀胱肿瘤的体会（附47例报告）

目的:总结高龄T3期膀胱肿瘤行全膀胱切除并输尿管皮肤造瘘的经验。方法:2004～2011年,47例超过75岁T3期膀胱肿瘤患者接受全膀胱切除并输尿管皮肤造瘘,9例为初发,38例为复发肿瘤,既往平均手术次数(2.7±1.7)次。25例(53.2%)合并有其他器官的慢性疾病。所有患者于术中同时行双侧盆腔淋巴清扫,1例因尿道腔内肿瘤生长行尿道全切除并阴道前壁部分切除。术后输尿管内留置F7单J支架管并定期更换。以QLQ-C30(v3.0)中文版量表评价患者术前,术后6个月,12个月的生活质量。结果:47例均顺利完成手术,无术中或围手术期死亡病例。手术平均时间(266±33)min,围手术期平均输血(728±309)ml。术后病理分级T2b2例,T3a26例,T3b15例,T4a4例,N214例,N31例。随访11～67个月,平均(32.4±15.1)个月。23例(48.9%)术后3～36个月出现肿瘤复发及转移。24例(40.4%)随访中死亡,17例死于肿瘤转移,7例死于非肿瘤相关原因。23例生存至今,19例(40.4%)无瘤生存15～67个月,平均(41.5±16.2)个月,4例(8.5%)带瘤生存19～30个月。17例(36.2%)出现并发症:7例单侧肾功能下降,1例双侧肾功能减退。11例经历至少1次肾盂肾炎(2例合并单侧肾功能减退)。32例完成术后6个月QLQ-C30测定,22例完成术后12个月测定,经统计检验,术后6个月患者情绪功能改变以及术后6个月,12个月患者的主观健康状况及生活质量均与术前存在显著统计学差异。结论:高龄T3期膀胱肿瘤患者可耐受全膀胱切除,应于术中尽量缩短手术时间,缩小手术区域,以提高患者手术耐受能力。对于高龄患者,输尿管皮肤造瘘并于输尿管内长期留置输尿管支架是全膀胱切除后简便,安全,并发症少且处理简单的尿流改道方式。全膀胱切除术对提高高龄T3膀胱肿瘤患者术后生活质量和主观健康状况有积极意义。     

慢性肾功能衰竭患者血浆心钠素和肾素、血管紧张素Ⅱ、醛固酮变化的观察及临床意义的探讨

本文用RIA法测定30例健康人、CRF24例非透析病人和14例血透病人的血浆ANP、PRA、ATⅡ、ALD水平。结果表明CRF病人ANP、PRA、ATⅡ、ALD明显高于对照胆（P<0.05～0.01）,其中高血压组ANP明显高于非高血压组（P<0.05）,血透后ANP明显下降（P<0.01）。ANP和Scr、MAP呈正相关,ANP、ATⅡ均和A呈负相关。结合文献初步探讨了CRF时,ANP和PAS的临床意义。     

小儿输尿管原发性纤维上皮息肉

小儿输尿管多发性纤维上皮性息肉临床少见，为原发性良性肿瘤，以腰腹部酸胀为首发症状，无特异性，极易漏诊，本院自1996年1月至2004年2月共诊治输尿管多发性息肉86例，其中小儿输尿管多发性纤维上皮性息肉仅3例，报告如下。