膀胱肿瘤2350例临床病理学特点分析

目的 探讨膀胱肿瘤的发病现状、总体趋势和病理特点.方法 整理1980-2007年2350例膀胱肿瘤病理档案,分为1980-1989、1990-1999和2000-2007年3个时间段.应用SPSS 13.0软件分析3时间段患者性别、年龄及肿瘤组织学类型间的关系.结果 2350例膀胱肿瘤中男1854例,女496例.良性92例,恶性2258例,膀胱恶性肿瘤的发病人数逐年上升.发病高峰年龄从50～69岁推迟到60～79岁.1980-1989、1990-1999和2000-2007年3个时间段中男、女恶性肿瘤病例数分别为524例和113例(4.64:11 00)、589例和164例(3.59:1.00)、675例和193例(3.50:1.00),男性约为女性的3.80倍;3时间段男性发生膀胱尿路上皮癌年龄分别为(57.5±11.7)、(62.6±12.3)、(65.9±11.3)岁,女性分别为(58.7±13.6)、(60.7±12.1)、(65.8±12.0)岁,男女各年龄段分别比较差异有统计学意义(P<0.05).男性发生鳞状细胞癌、尿路上皮癌和腺癌年龄分别为(68.05±9.7)、(59.85±14.1)、(63.4±9.9)岁,差异有统计学意义(P相似文献   

多节段髓内星形细胞瘤的临床研究

目的 探讨不同年龄段、恶性程度不同的多节段髓内星形细胞瘤患者的诊治特点.方法 21例多节段(3个椎体节段以上)髓内星形细胞瘤患者均行后正中入路显微镜下肿瘤切除术,以UOA分值差(术后UOA和术前UOA差值)评估手术效果.以Logistic回归和多元线性同归分析统计学数据.结果 肿瘤性质直接影响肿瘤的切除程度(X2=10.41,P=0.03),高度恶性肿瘤只能大部切除或减压.年龄(X2=12.53,P=0.01)、肿瘤性质(X2=16.44,P=0.002)和部位(X2=27.12,P=0.04)影响近期手术效果(UOA分值差);青少年患者、低度恶性肿瘤手术效果较好,单纯累及胸段的患者手术效果差.结论 低度恶性或青少年多节段髓内星形细胞瘤患者应尽早手术,术后疗效满意.     

妇女叶酸增补中需要关注的问题

妇女围孕期增补叶酸能够有效预防神经管缺陷等疾病的发生。随着对叶酸研究的不断深入，叶酸补充中出现了诸多问题。本文简要综述了叶酸在服用方式以及基础和临床研究中出现的值得讨论、已经引起关注和需要进一步研究探讨的问题，并提出了深入研究叶酸可能的发展趋势。     

弥散张量成像对颅脑肿瘤与相邻脑白质纤维束解剖关系的评价

目的:评价弥散张量成像技术显示颅脑肿瘤与相邻脑白质纤维束解剖关系的价值。材料和方法:对5例正常志愿者及29例幕上星形细胞瘤及脑膜瘤进行弥散张量成像,在弥散各向异性图、彩色张量图及脑白质纤维束图上分析肿瘤与相邻脑白质纤维束的解剖关系,并对患者术前、术后的临床症状进行评价。结果:(1)9例脑膜瘤及11例Ⅰ-Ⅱ级星形细胞瘤推移相邻脑白质纤维束,患者术后临床症状明显改善。(2)6例Ⅲ-Ⅳ级星形细胞瘤及3例Ⅰ-Ⅱ级星形细胞瘤浸润、破坏相邻脑白质纤维束,患者术后的临床症状未明显改善。结论:弥散张量成像技术在显示颅脑肿瘤与相邻脑内主要白质纤维束的解剖关系方面具有重要价值,对神经外科术前治疗方案的确定具有重要指导作用。     

Arterial and venous effects of serotonin in the forearm of healthy subjects are not age-related

The influence of age on the regional arterial and venous effects of serotonin (5-HT) was investigated in 13 young (aged 22-31 years) and seven older (aged 50-69 years) healthy volunteers. Single-dose infusions of 5-HT (1, 10, and 80 ng/kg/min) and of the 5-HT2 receptor antagonist ritanserin (50, 150, and 500 ng/kg/min) were administered into the brachial artery. Subsequently, the relative arterial and venous effects of the highest dose of 5-HT were investigated. Forearm blood flow (FBF) and maximum venous outflow (MVO) were measured by venous occlusion plethysmography. Heart rate (HR) and intraarterial (i.a.) blood pressure were recorded semicontinuously. In both age groups, 5-HT induced an initial transient arterial dilation, followed by a persistent increase in FBF for the doses of 1 and 10 ng/kg/min and a relative small decrease in FBF for the highest dose. In both age groups, the highest dose of 5-HT induced a similar large reduction in MVO (p less than 0.05 for both). The reduction in MVO was attenuated by ritanserin (500 ng/kg/min, p less than 0.05 for both groups). In the younger subjects, this dose of ritanserin also unmasked an arterial dilator effect of the highest dose of 5-HT (p less than 0.05). The single infusions of ritanserin did not influence FBF significantly in either study group. No significant differences were observed between the age groups. These results show that in the forearm of healthy subjects arterial and venous vascular responses to 5-HT were not age-related. In the arterial vascular bed, 5-HT acted predominantly as a vasodilator; at high doses, mainly venous vasoconstriction was observed.(ABSTRACT TRUNCATED AT 250 WORDS)     

女性吸毒者心理防御机制及心理健康状况研究

目的探讨女性吸毒者的心理防御机制与心理状况及二者的关系.方法分别用防御方式问卷(DSQ)和症状自评量表(SCL-90),对110名女性吸毒者(研究组)和41名女大学生(对照组)进行调查.结果研究组不成熟防御机制、中间型防御机制和掩饰因子评分(4.83±0.97,4.99±0.75,5.98±1.17)显著高于对照组(3.95±0.68,4.26±0.73,5.41±1.34)(P＜0.01或P＜0.05);研究组SCL-90中9个因子评分均显著高于对照组(P＜0.01);相关分析发现,研究组不成熟防御机制与SCL-90中9个因子均存在非常显著正相关(P＜0.01),中间型防御机制与SCL-90中的强迫、偏执、躯体化、抑郁存在显著正相关(P＜0.01或P＜0.05),掩饰因子与SCL-90中的敌对、偏执、强迫呈显著正相关(P＜0.01或P＜0.05).结论女性吸毒者过多地使用不成熟防御机制及中间型防御机制,心理状况差,且二者存在明显的相关性.     

老年人隐裂牙综合治疗的临床分析

目的：评价老年人隐裂牙综合治疗的临床效果。方法：对114例隐裂牙进行综合治疗，1年后随访观察。结果：114颗隐裂牙中，根管治疗全冠修复的有效率为92．86％，充填治疗组有效率为87．5％。结论：综合治疗可以保留牙体组织并恢复咬合力，是老年人隐裂牙治疗较理想的方法。     

重症胆管炎23例临床治疗分析

目的：探讨急性重症胆管炎患者的手术时机和死亡原因。方法：回顾性分析23例急性重症胆管炎患者的治疗及预后情况。结果：死亡2例（手术死亡及传统治疗死亡各1例）。早期大剂量短期应用糖皮质激素患者休克得到纠正率85％，明显高于未用糖皮质激素患者休克纠正率50％。结论：急性重症胆管炎患者应在出现休克和（或）精神症状之前手术，对已出现休克的患者，应先给予充分的保守治疗，待病情稳定后再手术。贻误手术时机，严重合并症如多器官功能衰竭及高龄是死亡的主要原因。     

Intussusception in Taiwanese children: analysis of incidence, length of hospitalization and hospital costs in different age groups.

BACKGROUND AND PURPOSE: This study investigated the characteristics of intussusception in Taiwanese children of different age groups, including the incidence, length of hospitalization and hospital costs. METHODS: Children with a diagnosis of intussusception who were hospitalized from 1999 through 2001 were identified from a nationwide health insurance claims database. The incidence of intussusception was calculated by age, gender, and season. Length of hospitalization and hospital costs were also analyzed. RESULTS: A total of 6988 cases of intussusception were identified in Taiwan from 1999 to 2001. Among them, 4859 cases occurred in children below 15 years of age. The average incidence among children below age 15 years was 34.5 per 100,000, with a peak incidence of 118.8 per 100,000 observed among children younger than 24 months old. The highest incidence of intussusception in Taiwanese children occurred between 12 and 24 months of age. According to the data for patients below 15 years of age hospitalized for intussusception in year 2000, males were more likely to be affected than females (61.3% vs 38.7%). Intussusception-related hospitalizations were rare in infants in the first few months of life, increased in those 6 to 12 months old, and peaked among children 1 to 3 years old. Among the 952 patients with intussusception admitted to hospitals in 2000, 297 (31.2%) received surgery, incurring higher median medical costs (New Taiwan Dollars [NT dollars] 42,265 or US dollars 1234) and longer median hospital stay (6.2 days) than the 655 patients who did not require surgery (NT dollars 6290 or US dollars 185 for hospitalization of 2.4 days). CONCLUSIONS: The study found that the incidence of intussusception peaked in the second year of life in Taiwanese children. There was also a male predominance and lack of seasonal variation in incidence.     

Acute pancreatitis combined with acute Budd-Chiari syndrome as the initial manifestation of small cell lung cancer.

Tumor metastasis to the pancreas is a rare but recognized cause of acute pancreatitis. Autopsy series have reported a 24-40% of pancreatic involvement in small cell lung cancer. However, only a very few cases of tumor-induced acute pancreatitis have been described. Budd-Chiari syndrome complicating lung cancer is a rarely reported condition. We report a 68-year-old woman with extensive small cell lung cancer with the unusual initial presentation of both acute pancreatitis and acute Budd-Chiari syndrome. This patient suffered from progressive epigastralgia for 3 weeks. Severe epigastralgia with radiation to back and progressive jaundice developed 2 days prior to admission. After admission, the liver enlarged rapidly and the ascites increased markedly. Chest roentgenogram showed a mass lesion over the left lower lung field. Poorly differentiated carcinoma cells were found in ascites and bone marrow. The patient died on the ninth day of hospitalization before chemotherapy was initiated. Prompt diagnosis of extensive-stage small cell lung cancer may allow early chemotherapy treatment which favorably influences recovery when the pancreatitis is mild. Although prolonged survival might have been expected had this patient recovered from pancreatitis and received chemotherapy, diagnosis was delayed due to difficulty in immunohistochemical diagnosis of the tumor and the unusual clinical presentation. The use of stains employing antibodies against neurofilament and neuron-specific enolase cell antigens is important for early diagnosis of poorly differentiated metastatic tumor cells.