经闭孔无张力尿道中段悬吊术治疗女性压力性尿失禁的观察

目的探讨经闭孔无张力尿道中段无张力悬吊术（TVT-O）治疗女性压力性尿失禁（SUI）的效果。方法41例SUI患者行经耻骨后径路无张力阴道吊带术（TVT）18例,行TVT-O术者23例,术后随访6～24个月,比较两组疗效。结果两组治愈率比较差异无显著性（〉0.05）,TVT-O组较TVT组手术时间短、出血量少,差异均有统计学意义（〈0.05）。两组患者均未出现严重膀胱损伤或穿孔,吊带排斥或伤口感染,阴道穿孔等并发症。结论TVT-O治疗SUI具有操作简单、安全、出血少及并发症轻微的特点,是较理想的治疗方法。     

5-氟尿嘧啶对创伤性胰外瘘的治疗作用

本组３例均为胰体尾部挫裂伤术后并发了胰外瘘，男性２例，女性１例，年龄１５～４８岁。病程为腹部探查术后４～３５ｄ。２例患者腹腔引流液为清亮的胰液，胰液日流量２００～３５０ｍｌ左右。１例属于过早的排除腹腔引流管后，引流口溢出清亮的液体，不断地浸湿敷料和外敷的卫生纸，日用卫生纸４～５包不等。２例患者伴有低热，１例有左上腹部胀痛和轻度贫血貌，腹壁瘘口红肿，有淡黄色渗出物粘附。引流液淀粉酶测定 １２１４～１５３６Ｕ。 １倒尿淀粉酶 １５３８．４Ｕ。血常规１例Ｈｂ９８ｇ／Ｌ，２例ＷＢＣ轻度增加，１例血常规正常…     

肾上腺肿瘤DNA含量测定的临床意义

为明确DNA含量可否作为肾上腺肿瘤良恶性诊断的指标 ,采用FCM技术对肾上腺嗜铬细胞瘤 10例以及肾上腺皮质肿瘤 7例新鲜标本进行了DNA含量的测定。6例病理为皮质腺瘤标本 ,2例DNA含量为非整倍体 ,其中 1例出现肝转移而确诊为恶性 ,1例皮质腺癌为二倍体的患者无瘤生存 ,而肾上腺嗜铬细胞瘤以及瘤旁肾上腺标本DNA含量均为非整倍体 ,但病理学及随访均不支持恶性。认为采用FCM技术测定肾上腺肿瘤DNA含量对判断皮质肿瘤良恶性可能是一项重要方法 ,但对嗜铬细胞瘤的作用不大     

心包填塞患者十例护理与监测体会

急性心包填塞是心脏直视手术后一种严重的并发症，临床并非罕见。献报道在2％～3%。我院于1985年5月至1996年6月共完成心脏直视手术797例，并发心包填塞10例，占1.25％。现报告如下：     

遗忘型轻度认知功能损害患者认知特征与低密度脂蛋白受体相关蛋白1基因的关联研究

Objective To investigate the relationship between neuropsychological characteristics and low density lipoprotein receptor related protein 1 (LRP1) gene C766T polymorphism in amnestic mild cognitive impair-ment (Amci). Methods 109 Amci patients and 104 matched normal controls were recruited for the study. Multi-dimension neuropsychologic tests were used to extensively assess the cognitive function. Assay-on-demand was used to analyse LRP1 gene C766T polymorphism in the subjects. Results The scores of neuropsychologic tests in Amci patients were significantly lower than those in the normal controls ( all P<0.01), with the largest im-pairment on 20 minute delayed recall of the auditory verbal memory test (AVMT) ,which reflects episodic memory [Amci patients :3 (0-4) ,normal controls :7.5 (6～12), Z=-12.697, P<0.01]. No significant differences were found for the genotype and allele distribution of C766T polymorphism between Amci patients and the normal controls. C766T polymorphism was not associated with cognitive assessment scores in Amci patients (P>0.05). Conclusion Amci is characterized by episodic memory impairment;and LRP1 gene C766T polymorphism may not be an important genetic factor in susceptibility to aMCI.     

膀胱滑动性疝3例报告

例1、男性,52岁。因右腹股沟区可复性包块3年,于1989年9月15日诊断为右腹股沟直疝手术治疗。术中切开疝囊有多量淡黄色液体流出,自认为是腹水,行疝修补术。术后7天内可见肉眼血尿。继后病人发现膀胱充盈时耻骨右上方可见乒乓球大囊状包块,排尿后包块消失。六月后疑疝术后复发入     

细胞因子诱导的imDCs鉴定及免疫学功能研究

目的:分析未成熟树突状细胞(immature dendritic cells,imDCs)的免疫学功能,诱导同种异体复合组织移植局部免疫耐受性。方法:采用细胞因子诱导培养黏附法,取大鼠骨髓前体细胞,粒细胞-巨噬细胞集落刺激因子联合白细胞介素-4细胞因子诱导下培养7 d,收集贴壁细胞光学显微镜观察imDCs的形态学特征,用质量分数2%锥虫蓝染色检测活性细胞率;应用流式细胞仪分析imDCs表面标志分子;MTT比色法测定imDCs与同种异体T淋巴细胞混合培养后T淋巴细胞的增殖能力。结果:制备诱导培养的imDCs具有形态不规则、表面粗糙层叠状皱褶、胞质突起短而多、树枝样分叉明显等典型形态特征;活性细胞率高达93%;表面较特异标志分子OX62为(61.08±4.86)%,OX62阳性细胞表达CD80、CD86、组织相容性复合体-Ⅱ表达率分别为(3.56±0.73)%、(5.38±1.09)%、(6.45±0.74)%,均为较低表达;imDCs对同种异体T淋巴细胞基本无刺激增殖能力。结论:用细胞因子诱导培养黏附法取骨髓前体细胞,可较快分选出活性和纯度较高、数量足够的imDCs,为同种异体复合组织移植诱导免疫耐受防止排斥反应的研究奠定良好的基础。     

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??Abstract?? Objective To summarize the clinical features of hepatic glycogen storage disease to improve the diagnosis and treatment and decrease the possibility of misdiagnosis. Methods Twelve cases of hepatic glycogen storage disease in Shengjing Hospital from May, 2007 to November, 2013 were analyzed retrospectively and followed up. Results Two cases were misdiagnosed in the 5 final diagnosed cases at first treatment. Liver dysfunction and growth retardation are the main symptoms, 2 cases with low blood glucose and 3 cases with jaundice??4 cases were screened positive result for epinephrine stimulating test. Two time of follow-up confirmed these cases still suffered from hepatomegaly and splenomegaly, liver dysfunction, growth retardation, etc. In suspected diagnosed group,only 1 case was screened positive result for epinephrine stimulating test. Conclusion The clinical manifestations of hepatic glycogen storage disease are multiple. Therefore, physicians should have sufficient recognition for this disease and give a right and prompt diagnosis based on family history, physical examinations and laboratory findings.     

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??Histologic types of benign breast disease and the risk of breast cancer LIU Lu, ZHENG Xin-yu. Department of Breast Surgery, the First Hospital of China Medical University, Shenyang 110001, China
Corresponding author:ZHENG Xin-yu, E-mail: xyzheng126@126.com
Abstract Some histologic types of benign breast disease (BBD) increase the risk of breast cancer. Histologically BBD are classified into nonproliferative and proliferative disease with and without atypia. The risk is higher in women with proliferative disease with atypia followed by those with proliferative disease without atypia. Generally women with nonproliferative disease and without a family history of breast cancer have no elevation in breast cancer risk compared with women of similar age from the general population. However, it is less clear whether histologic entities such as complex sclerosing adenosis, radial scar, and papilloma are associated with increased risk in the absence of atypical hyperplasia.