麻黄素并吗啡硬膜外注射的术后镇痛效果

①目的　探讨麻黄素并吗啡硬膜外注射的术后镇痛效果。②方法　对１２６ 例泌尿外科开放手术后的病人进行间断硬膜外腔注射吗啡（２ｍ ｇ）、麻黄素（２０ｍ ｇ）,观察其镇痛效果,并与４０ 例单用吗啡（ ２ｍ ｇ）者进行对照。③结果　吗啡、麻黄素的镇痛作用强而持久,一次用药有效时间为（２８．４±３．５）ｈ,较对照组的（１８．１±２．６）ｈ 明显延长（ｔ＝ １７．１,Ｐ＜ ０．０１）。未见出现血压波动者。④结论　吗啡加麻黄素硬膜外腔注射是安全、长效的术后镇痛方法,特别适用于术后留置导尿或尿流改道的泌尿外科开放手术。     

静脉滴注阿奇霉素治疗非淋菌性泌尿生殖道炎106例

目的 :观察静脉滴注阿奇霉素治疗非淋菌性泌尿生殖道炎 (NGU )的临床效果。方法 :2 97例NGU病人 [男性 193例 ,女性 10 4例 ,年龄 (2 7±s8)a]分为 3组治疗。静脉滴注阿奇霉素组 (治疗组 )10 6例 ,用阿奇霉素粉针剂 0 .2 5 g加氯化钠注射液2 5 0mL ,iv ,gtt ,qd ;静脉滴注氧氟沙星组 (对照 1组 ) 73例 ,用氧氟沙星注射液 4 0 0mg加氯化钠注射液 2 5 0mL ,iv ,gtt ,qd ;口服阿奇霉素组 (对照 2组 )118例 ,用阿奇霉素片 0 .5 g ,po ,qd。 3组用药均首次加倍 ,疗程均为 7～ 10d。结果 :3组痊愈率分别为 80 .2 % ,6 0 % ,74 .6 % ,治疗组和对照 2组疗效差异无显著意义 (P >0 .0 5 ) ,并均高于对照 1组 (P<0 .0 5 )。结论 :2种阿奇霉素制剂治疗NGU效果均优于氧氟沙星 ,可作为目前治疗NGU的首选药物 ,静脉滴注阿奇霉素胃肠道反应较轻 ,可选择性用于对口服制剂不适应的病人     

王泽涛教授治疗泌尿生殖疾病经验举隅

收集整理王泽涛教授曾在俄罗斯医疗队工作期间用针灸治疗阳萎、无精症、遗精、遗尿、癃闭、石淋等病的临床治疗宝贵经验.文中体现中医辨证分型,异病同治,取穴少而精,疗效显著等特点.     

Success of de novo reimplantation of the artificial genitourinary sphincter

PURPOSE: We evaluate our experience with de novo reimplantation of the artificial genitourinary sphincter with a particular emphasis on mechanical and nonmechanical failure rates. De novo reimplantation is defined as implantation of an artificial sphincter following removal of a previously placed sphincter for erosion and/or infection and a waiting period of several months. MATERIALS AND METHODS: A retrospective analysis of more than 400 patients with an artificial sphincter revealed 23 who underwent de novo reimplantation between January 1983 and October 1998. All patients were men with a mean age of 66.5 years (range 16 to 88) and all had a urethral cuff. Reasons for cuff removal were erosion in 12 cases (52.2%), infection in 10 (43.5%) and intraoperative urethral injury in 1 (4.3%). Mean waiting period was 6.8 months (range 1.5 to 32) between explantation and de novo reimplantation. Mean followup was 32.6 months (range 1 to 108). RESULTS: Of the 23 patients 20 (87%) had no mechanical or nonmechanical failures and 3 (13%) had nonmechanical failures, including 2 patients (8.7%) whose cuff eroded into the urethra and 1 (4.3%) who had recurrent urinary incontinence which was successfully treated with implantation of a tandem cuff. There were no mechanical failures or infections in this group of patients. CONCLUSIONS: Our study suggests that de novo artificial sphincter reimplantation is an excellent treatment option. It is safe and associated with complication rates that are comparable to those of primary implantation.     

低频超声增透效应

50年前人们就发现了超声的增透效应，经过40年的研究对比发现低频超声（20kHz〈f〈100kHz）更有利于促进分子的透皮传输。低频超声之所以具有较高的增透效应是因为该频段有利于空化作用的发生。发生在皮肤表面附近的惯性空化作用在低频超声增透效应中发挥主要作用。影响低频超声增透效应的既有超声因素又有非超声因素。关于超声因素的研究已比较成熟，但有关非超声因素的研究报道还很少。人们已将低频超声增透效应用于药物透皮注入．并在积极进行将低频超声增透效应用于微创透皮检测的研究。此项研究充满机遇和挑战。     

女性泌尿生殖道支原体感染及耐药性的变迁

目的研究女性泌尿生殖道支原体感染及耐药性变迁。方法对2002年及2004年就诊的女性泌尿生殖道感染患者进行支原体培养及药敏检测,并对药物敏感性的变化进行分析。结果 2002年117例支原体培养阳性患者中,解脲支原体 (Uu)占82．9％,人型支原体(Mh)占2．6％,Uu与Mh混合感染占14．5％;2004年126例支原体培养阳性患者中,Uu占83．3％, Mh占4．0％,Uu与Mh混合感染占12．7％。2004年组与2002年组相比,支原体对美满霉素、强力霉素、交沙霉素的耐药率明显增高,对罗红霉素、阿齐霉素、克林霉素、氧氟沙星、司帕沙星、左旋沙星无明显改变。敏感率较高的依次为美满霉素、强力霉素、交沙霉素。结论支原体的耐药率高,且随着时间的变化,其耐药性也在发生变化。治疗支原体感染时尽量根据药敏结果用药。     

曲安奈德经皮渗透特性研究

目的评价曲安奈德经皮渗透的特性。方法采用Franz扩散池法,考察药物经完整皮肤和去角质层皮肤的体外透皮能力,并采用了胶带剥离、皮肤萃取法分别获取了皮肤角质层、去角质层皮肤样本,用HPLC法测定了样本中的药物含量,考察曲安奈德在皮肤不同层的分布情况。结果曲安奈德的24 h透过量去角质层皮肤约为完整皮肤的1.6倍;8 h透皮实验,高、中、低3个浓度角质层中药物含量基本相同,真皮层则存在浓度依赖现象。结论角质层是曲安奈德的透皮吸收重要屏障,但角质层对药物的储留有饱和现象,临床上应用时需特别关注。     

Mixed epithelial and stromal tumor of the kidney in a puerperal woman

Puerperal pyrexia is still rampant, especially in third world countries, and is usually due to puerperal sepsis, urinary tract infections, upper respiratory infection, and breast infection. Rarely, in third world countries like India, it may be due to tuberculosis, malaria, typhoid, and so on, which are also rampant in the general population. Mixed epithelial and stromal tumor of the kidney (MESTK) is a recently recognized subset of renal tumors composed mainly of smooth muscle cells in which epithelial structures are embedded. It usually occurs in middle aged and older women. In the present case report, a 36-year-old woman presented with puerperal pyrexia, possibly due to tuberculosis and with an incidental mixed epithelial and stromal tumor of the kidney causing complex ascitis and fever, which required nephrectomy that was followed by full recovery. This case report highlights the importance of keeping MESTK in mind even in younger women with asymptomatic renal mass. It also highlights the importance of keeping renal tumors in mind as a possibility and to perform proper investigations for adequate treatment and recovery.     

男性泌尿生殖层的层面解剖及其临床意义研究

目的 观察并描述男性泌尿生殖层的层面解剖学形态,探讨该层面在结直肠手术中的临床意义.方法 采用层面解剖学方法解剖10具男性尸体躯干与20具盆腔标本,系统地描述泌尿生殖层的解剖形态,并与相应腹腔镜下解剖结构相比较.结果 男性泌尿生殖层为泌尿生殖筋膜包被,整体结构可分3段——腹段、盆段和精索段.泌尿生殖层腹段头侧由泌尿生殖...     

DNA条形码技术在人体排出未知昆虫幼虫鉴定中的应用

目的 使用DNA条形码鉴定方法对两名儿童从尿道排出的不明昆虫幼虫进行鉴定,解决未知昆虫幼虫无法利用传统形态学鉴定方法进行鉴定的难题,为主诊医生后期制定针对性治疗方案提供科学依据。方法 以家长收集并送检的患儿从尿道排出的不明活体昆虫幼虫为材料,先进行图像采集和形态学描述,然后取部分昆虫幼虫组织提取基因组DNA,利用多细胞无脊椎动物线粒体细胞色素氧化酶I(COI)的通用引物进行DNA扩增,PCR产物直接从两端测序,DNA测序结果以MEGA6软件验证图谱确定为有效序列后,经拼接、去除通用引物序列,最终得到658 bp的COI基因片段碱基序列。上传数据与GenBank和BOLD数据库中的序列进行同源性比对,建立系统发育树。结果 序列测定结果与GenBank和BOLD中公布的白斑蛾蚋（Clogmia albipunctata）的COI序列相似性为100%。选取GenBank中与目的片段核苷酸序列比较所得相似性较高的7种物种序列,以红头丽蝇为外群,构建NJ树,发现昆虫幼虫的序列以及GenBank中的白斑蛾蚋聚为一类,毛蠓科的全部物种聚成一支,置信度高达100%。结论 根据实验结果可以判断这两名儿童...