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.     

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。     

CT血管成像对肝细胞癌合并肝动脉-门静脉分流的诊断价值

目的探讨CT血管成像（CTA）对肝细胞癌（HCC）合并肝动脉-门静脉分流（APS）的诊断价值。方法127例HCC患者分别接受肝脏多层螺旋CT动态增强扫描和DSA检查，间隔时间3-15d。所有患者进行CTA检查，并以DSA为标准，对照分析CT动态增强扫描基础上进行CTA成像对APS的诊断价值。结果DSA证实52例（40．94％）HCC患者合并APS，中央型33例，周围型19例。CT横断面与横断面基础上结合CTA诊断APS的敏感度均为94．23％（49／52），特异度分别为84．00％（63／75）和97．33％（73／75），正确率分别为88．19％（112／127）和96．06％（122／127），阳性预测值分别为80．33％（49／61）和96．08％（49／51），阴性预测值分别为95．45％（63／66）和96．05％（73／76）。CTA排除了横断面CT对4例中央型APS和6例周围型APS的假阳性诊断。与DSA比较，多层螺旋CT对APS的分型符合率达88．46％（46／52），其中，中央型90．91％（30／33），周围型84．21％（16／19）。CTA还直观地显示23例重度分流中央型APS的供血动脉，其中19例为肝固有动脉分支，4例为胃十二指肠动脉分支。结论在多层螺旋CT动态增强扫描基础上进行CTA成像，能有效提高APS诊断的特异度和正确率。     

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     

先天性输精管缺如患者生育问题的研究

自1988年至1991年共收治25例先天性输精管缺如患者,在20例行手术诊治术中15例用自体睾丸精索鞘膜制成人工精池囊,5例又在囊内放置用微涤纶制成的异质管。术中抽吸10例附睾内精子进行快速活化,其中5例活化成功,行人工授精,结果2例怀孕,1例已生育一女孩。认为该症是有生育可能的,但需要解决3个问题:(1)采用显微外科技术把附睾内部活着的精子取出一定数量;(2)选配好快速活化剂使精子快速活化成功;(3)用患者的精浆培养自己的精子。建议对梗阻性无精子症在用手术疏通精路的同时可以采用快速活化精子技术行人工授精,以提高生育的效果。     

AⅡ受体拮抗剂ACEI对慢性肾衰患者血浆ANF及RAS的影响

目的了解血管紧张素Ⅱ受体拮抗剂(ATRA)和转换酶抑制剂(ACEI)对慢性肾衰(CRF)高血压患者血浆心钠素(ANF)和肾素*.血管紧张素系统(RAS)的影响。方法受试者口服氯沙坦(Los组)或福辛普利(Fos组)连续12周，于治疗前和治疗后第4、8及12周测定坐位舒张压(SiDBP)、血清尿素氮(BUN)、血清肌酐(SCr)、ANF、血管紧张素Ⅰ(AⅠ)和血管紧张素Ⅱ(AⅡ)。用SPSS7.0软件作统计分析。结果经12周治疗，两组患者SiDBP均降至目标值。Fos组与治疗前比较，AⅡ下降，ANF和Scr升高(P<0.01)。Los组AⅡ明显升高(P<0.01)，ANF在短暂升高后降至治疗前水平，Scr无变化。结论ACEI可能对CRF高血压患者肾内灌注压有影响，ANF动态改变可作为肾内灌注压变化的指标之一。ATRA对肾内灌注压影响小于ACEI。     

RP—HPLC用于紫苏油及其习用品白苏油,野苏油的鉴别

本文采用RP－HPLC方法对紫苏油及其习用品白苏油、野苏油甘油酯进行了定性定量分析。利用HPLC分析油脂也为中药材真伪鉴别提供了一条有效途径。     

MRI同层动态增强对垂体微腺瘤的诊断价值

目的：分析垂体微腺瘤的MPd同层动态增强特征。方法：对40例临床怀疑为垂体微腺瘤的病人行同层动态增强MPd扫描，并绘出时间一信号强度曲线图。结果：40例病人中共检出垂体微腺瘤26例。同层动态增强后垂体微腺瘤的MPd表现为圆或椭圆形的低或稍低信号，似“充盈缺损”；垂体微腺瘤的最大信号强度多出现在注入造影剂后32～96s，以64s最明显。结论：同层MPd动态增强对垂体微腺瘤的诊断有较高价值。