鼻内镜下等离子止血在腺样体手术中的应用

目的探讨经鼻内镜电动吸割器切除腺样体,术中使用低温等离子止血方法的优势。方法将我院60例行腺样体切除的患儿随机分成两组,30例腺样体肥大患儿采用经鼻内镜电动吸割器联合低温等离子止血行腺样体切除（低温等离子组）,与同期30例经鼻内镜电动吸割器切除腺样体,用双极电凝止血相比（双极电凝组）。对两组术后出血、发热、鼻腔恢复正常通气时间、并发症等临床症状进行分析比较。结果两组在术后出血、发热、恢复正常通气时间、并发症等方面比较,差异均有统计学意义（均P﹤0.05）。术后平均随访6个月～1年,患者症状明显好转,无鼻腔粘连、腺样体肿大等发生。结论鼻内镜下切除腺样体,术中使用低温等离子止血,具有微创、痛苦小、出血少、疗效满意等特点,值得在临床推广。     

痛结宁胶囊治疗乳腺增生病的临床疗效观察

目的 :评价痛结宁胶囊治疗乳腺增生病的临床疗效。方法 :30 0例乳腺增生病病人随机分成两组。治疗组 2 4 0例 ,口服痛结宁胶囊 ,每次 3粒 ,1日 3次。对照组 60例 ,口服维生素 E,1 0 0 mg,1日 1次。疗程 3个月。用 Ridit检验分析疗效。结果 :治疗组治愈率 2 1 .67% ,总有效率 88.75 % ;对照组治愈率 1 1 .67% ,总有效率 46.67% ,治疗组疗效明显优于对照组 ( P<0 .0 1 )。结论 :痛结宁治疗乳腺增生病有较好的疗效 ,病程越短 ,疗效越好 ,延长治疗时间可以提高治疗效果     

Interstitial lung diseases in children

Interstitial lung disease (ILD) in children (chILD) is a heterogeneous group of rare respiratory disorders that are mostly chronic and associated with high morbidity and mortality. The pathogenesis of the various chILD is complex and the diseases share common features of inflammatory and fibrotic changes of the lung parenchyma that impair gas exchanges. The etiologies of chILD are numerous. In this review, we chose to classify them as ILD related to exposure/environment insults, ILD related to systemic and immunological diseases, ILD related to primary lung parenchyma dysfunctions and ILD specific to infancy. A growing part of the etiologic spectrum of chILD is being attributed to molecular defects. Currently, the main genetic mutations associated with chILD are identified in the surfactant genes SFTPA1, SFTPA2, SFTPB, SFTPC, ABCA3 and NKX2-1. Other genetic contributors include mutations in MARS, CSF2RA and CSF2RB in pulmonary alveolar proteinosis, and mutations in TMEM173 and COPA in specific auto-inflammatory forms of chILD. However, only few genotype-phenotype correlations could be identified so far. Herein, information is provided about the clinical presentation and the diagnosis approach of chILD. Despite improvements in patient management, the therapeutic strategies are still relying mostly on corticosteroids although specific therapies are emerging. Larger longitudinal cohorts of patients are being gathered through ongoing international collaborations to improve disease knowledge and targeted therapies. Thus, it is expected that children with ILD will be able to reach the adulthood transition in a better condition.     

根除幽门螺杆菌对胃增生性息肉的治疗作用

目的探讨幽门螺杆菌与胃息肉的关系及根除幽门螺杆菌对胃增生性息肉的治疗作用。方法选取2009年1月—2012年3月来该院治疗的胃息肉患者154例,根据胃息肉病理类型分为增生型组、炎性组、胃底腺型组及腺瘤型组,检测患者的幽门螺杆菌,分析幽门螺杆菌感染与不同类型息肉的相关性。对所有患者进行ESD法切除胃息肉,对幽门螺杆菌阳性的患者进行四联根除螺旋杆菌治疗。将清菌后的病人按清菌成功与否分为清菌成功组及清菌失败组,对两组病人进行随访观察,比较两组间息肉复发率有无差异。结果本研究发现154例胃息肉患者中,增生型72例,占46.75%,胃底腺型56例,占36.36%,炎性息肉15例,占9.74%,腺瘤型11例,占7.14%。Hp感染率由高到低依次为炎性>增生型>胃底腺型>腺瘤型。所有患者均完成ESD法息肉切除术,在随访观察中发现增生性息肉成功清除幽门螺杆菌后,明显低于其他病理类型的复发率,且清菌成功组的复发率明显低于清菌失败组。结论幽门螺旋杆菌感染与增生性息肉的发生关系密切,增生性息肉患者根除幽门螺杆菌后,不易复发,根除幽门螺杆菌对胃增生性息肉具有良好的治疗作用。     

自拟乳痛方治疗乳腺增生69例疗效观察

目的：观察自拟乳痛方治疗乳腺增生的疗效。方法选取2013年1月~12月来我院就诊的69例乳腺增生患者,所有患者均采用自拟乳痛方进行治疗,治疗时间1~7个疗程不等,记录乳房肿块评分以及乳房疼痛评分。结果共治疗69例患者,其中治愈30例;好转33例;无效6例;总有效率91.30%。结论自拟乳痛方治疗乳腺增生效果明显,安全可靠,值得推广。     

慢性胰腺炎增生性胰管上皮细胞线粒体DNA突变的意义

目的探讨慢性胰腺炎增生性胰管上皮细胞线粒体DNA调控序列D-环突变的意义。方法利用PCR技术扩增46份来自11例慢性胰腺炎不同程度的胰腺导管增生性上皮细胞和其各自正常组织的线粒体DNA全序列。使用核苷同源序列（BLAST）分析病变组织的线粒体DNA。结果9份标本D-环共有15个突变点，增生性导管上皮细胞D-环至少存在一个以上异常点。异常D-环随病变进展程度呈进行性增加趋势．从单纯性导管上皮细胞肥大性增生的26．1％增至腺瘤样增生的80．0％（P〈0．01）。结论D-环异常程度与病变程度近乎呈平行性发展，异常D-环可作为检测增生性胰管上皮性组织病变的标志物。     

经尿道等离子前列腺剜除术治疗高龄高危前列腺增生症

目的 探讨经尿道等离子前列腺剜除术治疗高龄高危良性前列腺增生(BPH)患者的安全性及疗效.方法 将70例高龄高危BPH患者随机分为两组,每组35例,分别行经尿道等离子前列腺剜除术(TUPKEP)和传统的经尿道前列腺电切术(TURP).比较两组患者的手术时间、出血量、前列腺腺体切除重量、术后膀胱冲洗时间、术后住院天数、术后国际前列腺症状评分(IPSS)、生活质量评分(QOL)、残余尿量(PVR)、最大尿流率(Qmax)等指标.对两组指标进行统计学分析.结果 TUPKEP组在手术的出血量、手术时间、术后膀胱冲洗时间以及术后的住院时间要明显小于TURP组(P＜0.05);TUPKEP组前列腺腺体切除重量大于TURP组(P＜0.05);两组患者术后随访3个月,残余尿、国际前列腺症状评分、生活质量评分差异均无显著性意义(P ＜0.05);TUPKEP组术后最大尿流率大于TURP组,两组比较有显著性差异(P＜0.05).结论 TUPKEP治疗BPH疗效确切,且安全性较好,特别适用于高龄高危的患者.     

Outcome of Transurethral Plasmakinetic Vaporization for Benign Prostatic Hyperplasia

Purpose

To assess the outcome of transurethral plasmakinetic vaporization (PKVP) in the management of benign prostatic hyperplasia (BPH).

Patients and methods

From August 2010 to May 2012, 60 patients with obstructive LUTS due to BPH were included in the study. All patients were evaluated by International Prostate Symptom Score (IPSS), general examination, digital rectal examination, PSA, routine laboratory examinations, pelvi-abdominal ultrasound, trans-rectal ultrasound, and uroflowmetry. Patients with Qmax of <10 mL/sec., an IPSS of >8 and a prostate volume of >40 mL underwent transurethral PKVP.

Results

Mean age of the patients was 66.8±4.5 years. The mean times of the operation, post-operative bladder irrigation, and post-operative catheterization were 63.8±13.9 minutes, 15.2±5.7 hours, and 23.9±5.2 hours, respectively. At 3 months of follow-up, there were significant reductions in the mean IPSS from 23.4±3.5 to 9.2±3.7 (P=0.4), mean PSA from 3.03±2.2 ng/mL to 1.2±1.04 ng/mL (P value=0.02), mean post voiding residual urine from 149.8±59.5 mL to 46.9±24.1 mL (P value <0.01), and mean prostate volume from 72.8±10.3 mL to 22.7±6.1 mL (P value <0.01). Also, there was a statistically significant increase in the mean Q max. from 8.7±2.4 mL/s to 19.5±3.5 mL/s (P value <0.01).

Conclusion

PKVP is an effective and safe treatment option in the management of symptomatic BPH.     

Insulin-like growth factor (IgF)-I,IgF binding protein-3, and prostate cancer: correlation with gleason score

Introduction

Non-androgenic growth factors are involved in the growth regulation of prostate cancer (PCa).

Objective

This is the first Brazilian study to correlate, in a population of patients operated for PCa, PSA, total testosterone, insulin-like growth factor-I (IGF-I) and insulin-like growth factor-binding protein-3 (IGFBP-3) with Gleason score and to compare with a control group with benign prostate hyperplasia (BPH).

Materials and Methods

This retrospective single-center study included 49 men with previously diagnosed PCa and 45 with previously diagnosed BPH. PSA, testosterone, IGF-I, IGFBP-3 were determined in both groups.

Results

PSA and IGFBP-3 levels were significantly higher in the PCa group as compared to the BPH group (p<0.001 and p=0.004, respectively). There was a significant difference when we compared the PSA before surgery (p<0.001) and at the inclusion in the study (p<0.001) and IGFBP3 (0.016) among patients with Gleason <7, ≥7 and BPH. In the PCa group, PSA, testosterone, IGF-I and IGFBP-3 levels were comparable between Gleason <7 and ≥7.

Conclusions

Our data suggest that in localized PCa, the quantification of PSA and, not of IGF-1, may provide independent significant information in the aggressiveness. IGFBP-3 could be a biochemical marker of disease control in PCa patients.     

Prostatic Arterial Embolization with Small Sized Particles for the Treatment of Lower Urinary Tract Symptoms Due to Large Benign Prostatic Hyperplasia: Preliminary Results

Background:The clinical failure after prostatic artery embolization (PAE) with conventional particles was relatively high,in treatment for lower urinary tract symptoms (LUTS) due to benign prostatic hy...