Complete urethral injury in the penile fracture: a case report and literature review

Penile fracture is described as a traumatic rupture of the tunica albuginea caused by blunt injury to the erect penis. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture with urethral injury is an extremely rare condition. Although its diagnosis is usually clinical, ultrasound plays an important role in confirming diagnosis and identifying the site of the injury. Here, we presented a case of penile fracture with complete urethral injury. A 43-year-old male was admitted to the hospital because of trauma to the genital and dysuria following sexual intercourse. After admission, the patient was diagnosed with double penile fracture and complete urethral injury after the physical and B-ultrasound examinations. Emergency surgery to remove the hematoma and repair the urethra was performed. The patient recovered smoothly and was discharged on the third day after operation. After two months’ follow-up, the patient urinated smoothly and achieved an adequate erection without other complications. In this case, consistent with previous studies, emergency surgery for penile fracture is necessary and can preserve the urethral function and sexual function. In addition, there are two lesions in tunica albuginea in this case, so careful search for the penile shaft during the surgery is important to avoid the missed injuries. This report provides evidence of an uncommon and underreported clinical case.     

经口入路机器人甲状腺手术的研究进展

近年来,甲状腺疾病的发病率逐年上升,其中青年女性患者占较大比例.随着年轻患者对美容的要求提高,多种入路的内镜甲状腺手术已广泛成功开展.这些术式尽管避免了在颈部做切口,并取得了较好的美容效果,但不可避免地在其他部位留下切口瘢痕.经口入路手术被认为是真正无痕的手术,具有更好的美容效果,随着近年来达芬奇手术系统的不断完善,经口入路机器人甲状腺手术也取得较大发展.与其他术式相比,经口入路机器人甲状腺手术具有多种优势,如提供中线入路、最低程度地减少组织损伤、3D高清放大视野、手臂震颤过滤及7个自由度Endo-wrist等.因此,本综述对近年来经口机器人甲状腺手术的研究进展进行总结,为临床甲状腺疾病的治疗提供学习借鉴.     

电阻抗断层成像技术用于呼气末正压滴定的研究进展

适当的呼气末正压（PEEP）是保护性肺通气策略的重要组成部分,PEEP可以保持肺泡开放,减少肺萎陷伤。尽管个体化PEEP已被越来越多的临床医师认可,但最佳的PEEP滴定方法尚存争议。电阻抗断层成像（EIT）是一种无创、无辐射的成像技术,可在床边实时动态评估肺功能,将肺通气过程中的阻抗变化以动态图像呈现,能够反映PEEP调整前后肺内通气及气体分布变化,因此,EIT可用于滴定个体化PEEP。本文简要概括EIT的基本原理及监测指标,阐述临床应用EIT指导下的PEEP（PEEPEIT）滴定方法,旨在加强对EIT的优点和局限性的理解,为优化个体化PEEP的设置提供参考。     

步枪立姿射击稳定性的力学特征

射击运动技术是衡量运动员水平的关键，它对运动员姿态控制的稳定性有相当高的要求。本文以步枪立姿运动为例，分析其姿态控制的力学特征，运用运动稳定性原理，求得人体上躯干最佳姿态控制角，并论证了人体躯干长度，前臂长度对稳定性的影响。最后将理论结果与对一些国内外著名运动员实测参数比较分析，证明了理论结论与实际基本相符。     

Studies an morphological typing of argyrophilic nucleolar organizer regions

Morphological typing of argyrophilic nucleolar organizer regions (AgNOR) in 300 caws of malignant tumors and 140 cams of benign lesions was analyzed and five morphological types of ApNOR were described in detail. In malignant tumors, the diffuse type (78%) was the most frequently seen, and in benign lesions, the nucleolar type (92.85%); the difference was thus highly significant (P < 0.001). The intranucleolar and aggregate types were not observed in benign lesions. There was no obvious difference in the proportion of the mixed type in benign and malignant lesions (P > 0.05). The relationship between grade of malignancy and morphological typing of AgNOR and its clinical significance are discussed.     

膝骨关节病的关节镜诊断治疗

目的 通过对79例84膝骨关节病的关节镜诊断治疗回顾性总结,探讨高效率、创伤小、疗效佳的方法。方法 采用关节镜微创技术,结合术前检查对膝骨关节病分为：软骨破坏型,滑膜类型,游离体型及半月板型,依此施行有针对性,局限化手术治疗。结果 69膝得到6mo-3a的随访,按膝关节综合评分表评分,优20％,良59％,可和差21％。结论 该方法具有创伤小、康复快、并发症少等优点,在病损严重的病例,全膝置换或截骨术是进一步提高总体疗效的适宜选择。     

导赤散加味治疗慢性前列腺炎110例

目的 了解导赤散加味对慢性前列腺炎的疗效。方法 应用导赤散为主组方,结合直肠指诊、化验检查进行综合分析,辨证加减用药、治疗慢性前列腺炎110例,并与口服环丙沙星片、回通淋丹组40例作对照。结果 治疗组近期治愈率36.4%,总有效率为91.0％,对照组近期治愈率仅15.0%,总有效率为72.5%,两组的有效率比较差异有显性（P＜0．05）。结论 导赤散加味治疗慢性前列腺炎有明显改善作用。     

雷公藤多苷治疗儿童肾病综合征的机制探讨

目的 :探讨雷公藤多苷在治疗儿童肾病综合征中的作用及其机制。　方法 :对 16年来在我科住院明确病理类型的 5 5 0例中 10 5例肾病综合征患儿 ,在激素逐渐减量的同时用雷公藤多苷 ( 1m g/ kg· d- 1 )治疗。　结果 :81例肾病综合征获得缓解 ,总缓解率达 77.1% ,其中 MCNS( 2 4例 )、Ms PGN ( 46例 )、MPGN ( 17例 )、MN ( 13例 )和FSGS( 5例 )的缓解率分别为 91.7%、89.1%、76 .5 %、38.5 %和 0 % ,FSGS效果最差 ;14例改善 ,10例无效。　结论 :由于病理类型不同疗效相差较大 ,临床上对激素治疗无效或耐药的肾病综合征患儿 ,应及时行肾活检以明确病理诊断 ,对病理类型为 MCNS和 Ms PGN者可单用雷公藤多苷治疗 ,以避免长期应用激素的不良反应 ,这是治疗儿童肾病综合征的有效方法之一     

阉割和睾酮替代对大鼠应激免疫抑制蛋白的影响

目的 :研究阉割和睾酮替代对束缚应激模型大鼠血清中应激免疫抑制蛋白的影响。方法 :成年雄性SD大鼠随机分为正常对照组、假手术组、阉割组、阉割后睾酮替代组。每组 10～ 12只。以上各组随机抽出一半给予束缚应激 ,另一半作为不应激对照。观察各组大鼠血清对ConA诱导的淋巴细胞转化的作用 ,作为反映血清中应激免疫抑制蛋白含量的指标。在离体实验中观察不同浓度的睾酮对淋巴细胞转化的直接作用。结果 :阉割可促进应激大鼠血清中应激免疫抑制蛋白的产生 ,睾酮替代可对抗这一作用。结论 :睾酮可在一定范围内对抗应激免疫抑制蛋白的产生。