急性生理和慢性健康评估系统对老年术后危重病人的应用价值

目的 探讨急性生理和慢性健康评分系统（APACHEⅡ）对老年术后患者病情危重程度评价的可靠性。方法 对40例术后直接人住ICU的老年患者应用APACHEⅡ评分系统评定的严重程度，记录患者术后并发症的发生率和死亡率以及人住ICU的时间。结果40例患者APACHEⅡ评分均值13．8分。并发症的发生率随着APACHEⅡ评分的升高而增加，χ^2=18．70，P〈0．01，差异有显著性。死亡组（死亡15例，占37．5％）的APACHEⅡ评分明显高于存活组，t=6．77，P〈0．01。并且随着APACHEⅡ评分的增加死亡率从0增加到83．3％。死亡组人住ICU的时间明显长于存活组，P〈0．01。存活组和死亡组年龄差异没有统计学意义。结论 APACHEⅡ评分系统对老年术后病人的预后的评估非常有价值，可以客观、准确的评估患者的预后并指导治疗，值得大家在工作中推广应用。     

A female case with Down syndrome and non-neurogenic neurogenic bladder

Although the prevalence of a learned voiding dysfunction and non-neurogenic neurogenic bladder (NNB), which is one type of dysfunctional elimination syndrome, is considered to be relatively rare, the association of NNB with Down syndrome (DS) has been elucidated in male patients. We herein describe the occurrence of NNB in an adult female with DS. The diagnosis was confirmed after completely ruling out any neurological or anatomical anomalies that could be related to a lower urinary tract dysfunction. She had renal dysfunction and multiple obstructive uropathies for which clean intermittent catheterization was successfully introduced.     

Liver and lung resection for colorectal metastasis

Aim: To examine the survival benefit of liver and lung resection for colorectal metastasis and the potential prognostic factors that affect patient survival. Methods: All patients who had resection of lung or liver metastasis for colorectal metastasis in Queen Elizabeth Hospital, Hong Kong from 1995 to 2004 were retrospectively reviewed. The overall and disease‐free survival was analysed, in particularly between liver and lung metastasis. All factors that may have affected the survival were entered into Cox's proportional hazards regression model to identify significant variables associated with survival. Results: At 5 years, the overall survival of patients who had resection of lung and liver metastasis was 44% and 38%, respectively; the disease‐free survival was 26% and 24%, respectively. Overall and disease‐free survival of patients with resection of lung metastasis was comparable to those with resection of liver metastasis. The differentiations of primary tumour and time to metastasis were shown to be significant prognostic factors influencing overall survival. Those patients with systemic chemotherapy after resection of colorectal metastasis demonstrated a significantly higher probability of overall survival. Conclusion: Resection of lung and liver metastases from colorectal origin was safe and both procedures improved survival. The use of chemotherapy after resection of metastasis significantly improved the overall survival.     

乳头溢液的外科治疗（附207例分析）

目的探讨乳头溢液的渗断和治疗方法，为合理的治疗提供科学依据。方法回顾分析手术治疗的207例乳头溢液病例资料。结果（1）在非哺乳期间发生乳头溢液多属病理性溢液；（2）通过美蓝法或平针头指示法行区段切除术，安全准确。结论（1）乳头溢液特别足血性溢液应手术治疗．对早期发现和早期治疗乳腺癌有鼋要的临床意义。（2）乳头溢液伴肿块者，不沧年龄大小、溢液性质均应手术治疗。     

25例垂体ACTH腺瘤的临床分析

目的分析和探讨垂体促肾上腺皮质激素(ACTH)腺瘤的临床特点和治疗方法。方法回顾性分析从2004年1月至2006年3月在我院接受治疗的25例垂体ACTH腺瘤患者的临床特点、治疗经过及预后。结果垂体ACTH腺瘤患者的临床症状和肿瘤的大小密切相关,微腺瘤(直径≤10 mm)患者以Cushing综合症征为主要临床表现,而大腺瘤(直径>10 mm)患者则以压迫症状为主。有无Cushing综合征的表现和腺瘤的直径呈负相关(P<0.05)。本组25例垂体ACTH腺瘤中21例具有侵袭性。垂体ACTH腺瘤患者主要以育后女性为主。该病首次经蝶手术后近期疗效显著。结论垂体ACTH大腺瘤以压迫症状为主,微腺瘤则以Cushing综合征表现为主。该肿瘤大多数具有侵袭性倾向,育后女性是高危人群。经蝶显微手术是垂体ACTH腺瘤的首选治疗方法。     

老年人脑卒中后抑郁症的发病机制及预防

[目的]探讨脑卒中后老年患者抑郁症的发病机制及预防措施。[方法]归纳相关资料,对命题进行分析。[结论]医护人员应采取针对性的用药及护理措施,预防患者卒中后抑郁症的发生。     

As_2O_3诱导人肝癌细胞凋亡及对Fas表达和钙含量的影响

化疗在原发性肝癌的综合治疗中占重要地位.为寻找肝癌治疗新的有效药物,我们观察了As2O3对人肝癌细胞株BEL7402的生物学效应,以期为As2O3临床治疗肝癌提供实验依据.     

彩色多普勒超声诊断Peutz-Jeghers氏综合征并肠套叠1例

患者 女，12岁，无明显诱因地腹痛，呕吐3天，急诊入院。查体：神志清晰，精神差，T36.5℃，P80次/min，R23次/min，血压13/9kPa，急性面容，呻吟不止，下唇有班状棕褐色斑点，     

松果体和褪黑激素通过下丘脑影响大鼠腹腔巨噬细胞化学发光(英文)

目的:研究松果体和褪黑激素(Mel)是否通过下丘脑影响腹腔巨噬细胞功能.方法:松果体切除术;腹腔巨噬细胞化学发光测定;下丘脑地诺前列酮放射免疫测定;下丘脑注射Mel.结果:松果体切除后腹腔巨噬细胞化学发光值降低,下丘脑地诺前列酮含量升高,16:00 ip Mel(10 μg kg~(-1)d~(-1)×7d)可使其恢复,并升高正常大鼠腹腔巨噬细胞化学发光值,降低其下丘脑地诺前列酮含量.腹腔巨噬细胞化学发光值与下丘脑地诺前列酮含量的变化存在负相关(相关系数,r=-0.78,P<0.01).于下丘脑注射Mel 2μg,能提高正常大鼠和松果体切除大鼠腹腔巨噬细胞化学发光值.结论:下丘脑是松果体Mel影响腹腔巨噬细胞功能的主要作用部位之一.     

组织扩张术皮肤胶原的代谢改变

目的：研究常规扩张（ＩＴＥ）和持续快速扩张（ＣＴＥ）对皮肤胶原代谢的影响。方法用白色小家猪制作组织扩张术动物模型，用Ｇｏｒｄｅｌａｄｚｅ法测定血清和扩张组织的羟脯氨酸（ＨＰ）含量，藻酸盐印模材膜片法测量标记区面积；光镜测量真皮厚度。结果：ＩＴＥ组血清ＨＰ含量升高，０．８倍，ＣＴＥ组升高１．２倍，ＩＴＥ和ＣＴＥ组皮肤含量与正常皮肤相同，组织中ＨＰ总量均明显升高，持续扩张皮瓣组（ＣＴＥＦ）术后４ｗｋ皮