人工破膜对诊断羊水过少的价值

目的 :探讨人工破膜在诊断羊水过少中的意义。方法 :观察组是根据人工破膜时所流出的羊水量判断羊水多少 ;对照组则用同期产前超声检查所见判断羊水多少。以产时所见羊水量作为最终诊断。结果 :人工破膜和超声诊断羊水过少的符合率分别是 79 73 %和 82 76 % ;两者无显著差异 (P >0 0 5 ) ;人工破膜漏诊率 2 84% ,超声是 6 15 % ,两者无显著差异 (P >0 0 5 )。结论 :人工破膜是诊断本病的一种有价值的方法 ,结合超声检查可作为诊断本病的依据     

RK术后严重眼球破裂伤的手术治疗：附3例报告

报告３例ＲＫ术后严重眼球破裂伤的手术效果。方法部分穿透性角膜移植及联合瞳孔孔成形,前段玻璃体切除,角膜裂伤修补及后段玻璃体切除视网膜复位术。结果３例均保存了眼球。结论ＲＫ术后眼球破裂伤虽然严重而复杂,但通过穿透性角膜移植术及联合手术治疗,仍有可能保存眼球和恢复部分视力。     

Cystoid macular edema in anterior chamber lens implantation following posterior capsule rupture

By comparing the incidence of cystoid macular edema (CME) in three groups of patients having different surgical procedures, we attempted to assess the role of vitreous loss as a risk factor for CME development. In the first group (n = 470), the surgical procedure was extracapsular cataract extraction followed by implantation of posterior chamber lens (EC-CE + PC-IOL). The second group (n = 42) had extracapsular cataract extraction which was complicated by posterior capsule rupture, and therefore anterior vitrectomy followed by implantation of anterior chamber lens had to be performed (ECCE + anterior vitrectomy + AC-IOL). In the third group (n = 22) the surgery was intracapsular cataract extraction followed by anterior chamber lens implantation (ICCE + AC-IOL). The third group was included in this follow up study to assess the role of AC-IOL as a possible causative factor for development of CME in uncomplicated cases of ICCE and AC-IOL. The difference of incidences of CME in the second and third group would therefore depend mostly on the vitreous loss. The incidence of CME diagnosed by fluorescein angiography in the first, second and third group was 1.5% (7/470), 35.7% (15/42) and 9.0% (2/22), respectively. All patients who developed CME were treated with combination of corticosteroid-antibiotic drops, dexamethasone retrobulbarly (40 mg/day) and peroral indomethacine (25 mg/day/6 weeks). This therapeutic regime resulted in only moderate improvement of visual acuity.Abbreviations AC-IOL anterior chamber intraocular lens - CME cystoid macular edema - ECCE extracapsular cataract extraction - ICCE intracapsular cataract extraction - IOL intraocular lens - PC-IOL posterior chamber intraocular lens     

Epidermoid cyst in a wandering spleen

A wandering spleen and splenic cysts are uncommon conditions in children. A combination of both entities has only rarely been reported in the literature. Another case of this complex pathology in 12-year-old girl is presented. She was initially referred for evaluation of a large abdominal mass. Diagnostic studies raised the suspicion of a hematoma in an abnormally located spleen, but the definitive diagnosis was established at laparotomy. Successful surgical management consisted of total cystectomy and splenopexy. Accepted: 6 November 1997     

Long-term survival following emergency abdominal aortic aneurysm repair

Survival following emergency surgery for ruptured abdominal aortic aneurysm remains poor and is in stark contrast to that for elective repair. We have carried out a 5-year retrospective observational study to determine the long-term (5-year) survival of patients following emergency surgery for ruptured abdominal aortic aneurysm at a district general hospital in East Anglia. A total of 99 patients presented to the operating theatre for emergency repair of ruptured abdominal aortic aneurysm in this 5-year study period. In-hospital mortality was 70% and was unchanged over the 5 years. Overall long-term survival in those patients discharged from hospital was good. The ICU cost per long-term survivor was calculated to be pound sterling 36750.     

围生因素与新生儿肺透明膜病发病关系的探讨

目的探讨围生因素与新生儿肺透明膜病(HMD)发病的关系。方法对481例早产儿围生因素进行Logistic回归分析,筛选出与HMD有关的因素,列出回归方程,然后对其进行率的比较及卡方检验。结果HMD危险因素的主效应模型是logit(p)=6.254-0.204胎龄-1.556出生体重 0.834窒息/宫内窘迫 1.635胎膜早破。对于有围生期合并症的早产儿,其胎龄越小,HMD发病率越高。结论30周以下早产儿HMD发病主要与胎龄、出生体重关系密切,而30周以上早产儿HMD发病除与胎龄、出生体重有关外,还与围生因素密切相关,其发病机制有待进一步研究。     

肾动脉瘤14例诊治报告

为探讨肾动脉瘤(RAA)的特点和诊治方法,回顾性分析2015年6月-2019年10月我院收治的14例RAA患者的临床资料.14例患者中,男8例,女6例;年龄40～77岁,平均59.1岁;左肾RAA 6例,右肾RAA 7例,双肾RAA 1例;体检发现8例,表现为腰腹部疼痛5例,表现为血压骤升1例;2例RAA破裂,1例表现...     

Post‐COVID‐19 splenic infarction in a patient with chronic atrial fibrillation: A case report

We describe splenic infarction (SI), an infrequent condition, in an 82‐year‐old COVID‐19 patient with chronic atrial fibrillation (AF). COVID‐19 may cause thrombosis, and AF is a predisposing factor for splenic infarction. Suspicion of SI may be warranted in COVID‐19 patients with abdominal pain, especially if a predisposing factor exists.     

Isolated splenic metastasis of endometrial cancer 12 years after treatment: A case report and literature review

Rationale:The spleen is an uncommon metastatic organ for malignant solid tumors because of its special anatomy and microenvironment. Isolated splenic metastasis of endometrial cancer is an extremely rare clinical event, with only 17 cases reported in literature.Patient concerns:We report the case of a 58-year-old woman with abdominal distension and nausea for 7 months who had undergone surgery and chemotherapy for endometrioid adenocarcinoma 12 years previously. A space-occupying lesion in the upper pole of the spleen was observed on an abdominal ultrasound.Diagnosis:The spleen was resected, and splenic metastasis of endometrial adenocarcinoma was histologically confirmed.Interventions:Splenectomy was performed, and no lymph nodes or other metastases were observed. The patient received postoperative chemotherapy with 6 cycles of docetaxel and carboplatin.Outcomes:The patient recovered well 11 months postoperatively, with no evidence of recurrence or metastatic disease.Lesson:Since the time interval between the diagnosis of primary endometrial cancer and splenic metastasis may be very long, it may be necessary to monitor the recurrence of endometrial cancer after primary treatment.     

The bevacizumab plus oxaliplatin-based chemotherapy regimen is more suitable for metastatic colorectal cancer patients with a history of schistosomiasis: a clinical retrospective analysis

BackgroundThe basic platelet counts of schistosomiasis patients are low. If it does not meet the requirements for chemotherapy, the patient’s treatment will not be carried out, which directly affects their prognosis. Therefore the impact of treatment on platelet counts is critically important. The effects of bevacizumab plus oxaliplatin-based chemotherapy and bevacizumab plus irinotecan-based chemotherapy regimens on platelets are different but have not been determined. In order to find a more suitable plan for metastatic colorectal cancer (mCRC) patients with a history of schistosomiasis, we conducted a retrospective analysis of mCRC patients and evaluated the impact of bevacizumab on their platelets.MethodsThe medical records of all mCRC patients with a history of schistosomiasis who received oxaliplatin-based chemotherapy or irinotecan-based chemotherapy as first-line treatment for no less than 4 cycles, with or without bevacizumab from September 1, 2017, to June 30, 2019, in Kunshan Hospital were reviewed. Six-month cumulative incidence rates of splenomegaly and thrombocytopenia of chemotherapy with and without bevacizumab groups, oxaliplatin-based chemotherapy with and without bevacizumab groups, irinotecan-based chemotherapy with and without bevacizumab groups were compared from the first cycle until the completion of chemotherapy using Kaplan-Meier analysis and Log-rank test.ResultsEvaluable splenic enlargement and thrombocytopenia results were obtained from 153 mCRC patients. The 6-month cumulative incidence rates of splenomegaly (23.3% vs. 55%; P=0.01) and that of thrombocytopenia (43.8% vs. 57.5%; P=0.40) were lower in the bevacizumab group than the non-bevacizumab group, however there were no statistical differences for the rates of thrombocytopenia. For patients treated with oxaliplatin, the rates of splenomegaly (19.5% vs. 66.7%; P=0.01) and thrombocytopenia (31.7% vs. 77.2%; P=0.02) were lower in the bevacizumab-treated cohort than that in the non-bevacizumab cohort. When stratified for irinotecan, there were no statistical differences in the frequency of splenomegaly between the two groups. However, the rates of thrombocytopenia were higher in the bevacizumab-treated cohort than that in the non-bevacizumab cohort (59.4% vs. 8.7%; P=0.01).ConclusionsThe bevacizumab plus oxaliplatin-based chemotherapy regimen is safer for mCRC patients with a history of schistosomiasis, especially for patients with a lower platelet count.