先天性17-α羟化酶缺乏1例

1临床资料患者女，15岁，四肢无力1周入院。1周前无明显诱因出现双侧腓肠肌酸痛、僵硬，继而四肢无力，5天前不能抬腿，双手无力，不能拿碗筷，于当地医院静脉输液补钾后，四肢无力和酸痛逐渐好转，但次日曾腹泻1次，行走时腿软、无力再次加重。我院急诊查：血钾2.1mmo1/L，肌酸激酶23856U/L，乳酸脱氢酶1309U/L。常规补钾，血钾继续下降，心肌酶持续升高。2年前曾感四肢无力，自行好转。2周前曾军训，有慢性鼻窦炎和咽炎5年，无月经来潮。父亲患糖尿病和高血压病4年，父母非近亲结婚，姐体健。体检：P105次/min，BP180/100mmHg，心律齐…     

肾上腺髓质增生二例报告

肾上腺髓质增生二例报告钟甘平秦大山陈一戎段国兰史庭凯刘国栋例１，女性，２６岁。因阵发性高血压伴头痛、头晕、心悸、多汗６个月，于１９９４年８月４日入院。体格检查：血压２４０／１３．３ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ）。实验室检查：血、尿常规正常，尿Ｖ...     

表小檗碱对α受体的作用

表小檗碱(epiberberine,EB)是从湖北产黄连(Coptis chinensis Franch)中提取的一种生物碱,属苯喹嗪类原小檗碱,对其药理作用的研究资料甚少,未见其对α肾上腺素体作用的报道。资料表明,许多原小檗碱类化合物有α受体阻滞作用,为从该类化合物中选择     

肾上腺疾病MR与B超CT比较：附25例分析

收集经Ｂ超、ＣＴ和ＭＲ检查诊断肾上腺疾病２５例，其中肿瘤１８例，增生７例，１５例行手术切除，另１０例保守观察，将ＭＲ影像学特征与Ｂ 超和ＢＴ进行比较，结合病理诊断和生化结果评价ＭＲ在肾上腺疾病诊断中的价值。     

肾上腺皮质肿瘤致男性女性化三例报告

肾上腺皮质肿瘤致男性女性化三例报告程双管，张炜，尤国才自１９８５～１９９５年我科共收治肾上腺皮质肿瘤致男性女性化病人３例。报告如下。例１，５２岁。因头痛头昏伴女性化乳房增大１年半，上腹胀痛３个月于１９８５年１０月收治。患者伴性欲消失，阳萎，面部潮红，...     

大鼠带皮质细胞的肾上腺被膜与单纯肾上腺被膜对自体移植…

对大鼠带皮质细胞的肾上腺被膜与单纯肾上腺被膜进行自体肾被膜下移植，通过组织学检查与血皮质酮测定结果发现，带皮质细胞的肾上腺被移植有五变怀，部分坏死而后再生的过程，而纯肾上腺被膜种植则无此过程，而是直接再生。前者明显较后者再生迅速，完全，功能好。     

Rapid effect of stress concentration corticosterone on glutamate receptor and its subtype NMDA receptor activity in cultured hippocampal neurons

Objective: To study the rapid effect of glucocorticoids (GCs) on NMDA receptor activity in hippocampal neurons in stress and to elucidate its underlying probable membrane mechanisms. Methods: Whole-cell patch-clamp recording was used to assess the effect of stress concentration corticosterone (B) on the responses of cultured hippocampal neurons to glutamate and NMDA (N-methy-D-asparatic acid). To make clear the target of B, intracellular dialysis of B(10μmol/L)through patch pipette and extracellular application of bovine serum albumin-conjugated corticosterone (B-BSA, 10μmol/L)were carried out to observe their influence on peak amplitude of NMDA-evoked current. Results: B had a rapid, reversible and inhibitory effect on peak amplitude of GLU-or NMDA-evoked current in cultured hippoeampal neurons. Furthermore, B-BSA had the inhibitory effect on INMDA as that of B, but intraeeUularly dialyzed B had no significant effect on INMDA. Conclusion: These results suggest that under the condition of stress, GCs may rapidly, negatively regulate excitatory synaptic receptors-glutamate receptors (GluRs), especially NMDA receptor (NMDAR) in central nervous system, which is mediated by rapid membrane mechanisms, but not by classical, genomic mechanisms.     

团结奋斗,努力追赶泌尿科学的世界先进水平

泌尿外科(Urology)是研究泌尿、男生殖系统和肾上腺疾病的临床学科，在某些医院也称为泌尿科。泌尿科学是外科学发展较早的一个分支，其研究范畴不仅包括上述疾病的诊断和治疗，也包括它们的病因学、发病机理和流行病学研究。     

肾上腺组合性嗜铬细胞瘤四例报告及文献复习

Objective To discuss the clinical characteristics and management principles of com-posite pheochromoeytoma of adrenal gland (pheochromocytoma-ganglioneuroma). Methods Four cases of composite tumor of adrenal gland diagnosed pathologically were reviewed. All the cases were male, aged 37 to 62 years;three of them had the history of hypertension, one of them accompanied with paroxysmal palpitation, while one case was asymptomatic. Computerized tomography and ultra-sonography showed single tumor in adrenal, the diameter was about 2.5、3.8、6.3、15cm respectively. Two cases showed positive results in 131Ⅰ-metaiodobenzylguanidine (MIBG) scintigraphy. One case showed positive result in 99Tcm-hydrazinonicotinamide-3trysinoctreotide (HTOC) scintigraphy. Twenty-four hours urinary catecholamine examination revealed the average of norepinephrine, epi-nephrine and dopamine were (196.1±92.2)nmol/24 h, (26.6±8.9)nmol/24 h, (1957.9±913.5) nmol/24 h respectively. Two cases were at a little elevated level and the others with normal. All cases were managed with α-adrenergic receptor blocker preoperatively for 2-4 weeks. Results Tumor re-section was performed in all 4 cases, and 3 cases by retroperitoneal laparoscopy, one by open surgery. All 4 cases were diagnosed as composite pheochromocytoma of adrenal (Pheochromocytoma-gangli-oneuroma) by pathology. All patients had no evidence of recurrence or metastasis during follow-up from 15 to 38 months. Two of three cases with hypertension reverted to normotensive. Conclusions Composite pheochromocytoma of adrenal is rare, difficult to be diagnosed preoperatively. Except mild in eatecholamine secretion, which clinical manifestations are similar to pheochromocytoma. Pheochro-mocytoma-ganglioneuroma is no apparent tendency for aggressive behaviors, the results of surgical management are favorable.     

后腹腔镜手术治疗嗜铬细胞瘤

目的探讨后腹腔镜手术治疗嗜铬细胞瘤的适应证及手术安全性. 方法采用后腹腔镜手术治疗肾上腺嗜铬细胞瘤患者15例(双侧2例),腹主动脉旁嗜铬细胞瘤1例.对照组为开放手术治疗的肾上腺嗜铬细胞瘤16例,腹主动脉旁嗜铬细胞瘤1例.结果后腹腔镜手术组16例患者行后腹腔镜手术18例次,17例次取得成功,1例因术中出血改行开放手术.肿瘤最大径2.0～6.5(3.8±1.6)cm.手术时间45～150(85±31)min,出血量10～100(32±22)ml.术后吗啡用量0～40(12.5±7.8)mg;术后恢复进食时间1～3(1.8±0.7)d;下床活动时间2～3(2.3±0.5)d;术后住院时间4～9(6.5±1.3)d.开放手术组肿瘤最大径1.5～6.0(4.3±1.3)cm.手术时间90～240(155±39)min,出血量50～600(273±105)ml,9例输血.术后吗啡用量10～120(61±24)mg;术后恢复进食时间2～4(2.9±0.5)d;术后下床活动时间3～6(4.8±0.7)d;术后住院时间8～11(8.8±0.9)d.结论对于有一定腹腔镜手术经验者,后腹腔镜手术并不增加嗜铬细胞瘤手术的危险性,且具有手术时间短、出血少、创伤小、疼痛轻、康复快等优点.该法有望成为治疗肾上腺嗜铬细胞瘤的首选手术方法.