78例肺脓肿致病菌及耐药性分析

目的:探讨引起肺脓肿的病原菌的分布及耐药情况,指导临床合理应用抗生素。方法:回顾分析我院1999年1月至2005年8月收治的78例肺脓肿的感染致病菌。结果:43例伴基础疾病的肺脓肿以革兰阴性杆菌感染为主,无基础疾病的以革兰阳性球菌居多,两者比较差异有显著性;革兰阴性菌中常见致病菌为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌和不动杆菌,对常用抗生素的敏感性为:亚胺培南92.3%,哌拉西林-三唑巴坦85.1%,头孢哌酮-舒巴坦77.7%,阿米卡星76.7%,头孢吡肟57.1%,环丙沙星52.8%。结论:在肺脓肿的起始经验性治疗时,伴有基础疾病的应首选抗革兰阴性杆菌的敏感药物,头孢吡肟、环丙沙星已严重耐药。     

CT三维表面遮盖与容积重建在骨盆肿瘤切除与重建中应用

目的:探讨螺旋CT三维表面遮盖重建(SSD)及容积重建(VRT)在骨盆肿瘤切除与重建中的临床应用。方法:使用SiemensPlus4螺旋CT机对17例骨盆肿瘤患者(男11例,女6例,年龄15~71岁,平均38岁)术前进行扫描,在Siemens工作站进行三维SSD及VRT。结果:术后创口延迟愈合1例,经引流Ⅱ期闭合伤口;术后16个月复发1例,行半骨盆切除及人工半骨盆重建后恢复健康,患者行走正常;肺部转移1例;其余病例在随访期内未发现局部复发。结论:螺旋CT三维表面SSD及VRT图像清晰地显示了术前骨盆肿瘤的细节,以最易理解的形式立体直观地显示了病变及与周围结构的关系及手术应切除的范围,有助于术前正确诊断和制定手术计划,有效地减少术后局部复发。     

Antitrichomonal activity of matrine,an active substance from Sophora flavescens

In an attempt to develop an antitrichomonal agent, the present study investigated the effect of matrine, one of the active principles isolated from the root of Sophora flavescens Ait. (Leguminoae), on the pathogenicity of Trichomonas vaginalis in two model system. First, it reduced the cytotoxic effect of this parasite towards mammalian cells in culture: at concentration lower than 1 mM it prevented the decrease of rate astrocytic cells in mixed culture with trichomonads. Second, it delayed the development of subcutaneous abscesses due to this parasite infection. It cured the intravaginal infection of trichomonads in mice. However, the antitrichomonal action of matrine was observed only with a combined intravaginal suppository and subcutanmeous injection, and it failed to produce the same activity through oral administration. The results suggest a potential for matrine as an antitrichomonal drug.     

椎管内脓肿的诊断与显微外科治疗

目的　为提高椎管内脓肿的诊断与显微外科治疗水平 ,回顾性分析经手术病理或细菌培养证实的 6 2例椎管内脓肿临床表现、诊断及治疗结果。方法　 6 2例中 ,男 36例 ,女 2 6例。脓肿位于硬脊膜外 37例 ,硬脊膜下 2 3例 ,脊髓内 2例 ,根据病史、临床表现 ,结合MRI与脊髓造影诊断 ,采用手术及早切除病变部位椎板 ,清除脓液及坏死组织。结果　本组随访 5 1例 ,优 2 7例 ,占 5 2 9% ;良 18例 ,占 35 3% ;可 6例 ,占 11 8%。优良率为 88 2 %。结论　对于椎管内脓肿 ,应结合病史 ,早期诊断 ,早期手术清除脓肿 ,可望获得良效。     

OVARIAN ACTINOMYCOSIS PRESENTING AS ACUTE PERITONITIS

Book reviews in this article: A patient with acute peritonitis due to ovarian actinomycosis and the association of this disease with the intrauterine contraceptive device is discussed. Because adequate treatment requires prolonged antibiotics the diagnosis should be sure. Unfortunately if antibiotics are given pre-operatively culture is usually unsuccessful and thus careful examination of all removed material is essential. As many of these women are of child bearing age surgical intervention should aim to preserve fertility wherever possible.     

Sonographic Diagnosis of Acute Hematogenous Osteomyelitis in the Early Stage

（康斌）（朱通伯）（杜靖远）（刘基仁）（黄建华）ＳｏｎｏｇｒａｐｈｉｃＤｉａｇｎｏｓｉｓｏｆＡｃｕｔｅＨｅｍａｔｏｇｅｎｏｕｓＯｓｔｅｏｍｙｅｌｉｔｉｓｉｎｔｈｅＥａｒｌｙＳｔａｇｅ￥ＫＡＮＧＢｉｎ，ＺＨＵＴｏｎｇ－ｂｏ，ＤＵＪｉｎｇ－ｙｕａｎＬＩＵ...     

Epidermoid tumor of the cauda equina presenting with urinary stress incontinence

Spinal cord tumors are a rare cause of urinary incontinence. Tumors of the spinal cord usually present with pain, not with isolated urinary complaints. We report a case in which a patient with an epidermoid tumor of the cauda equina presented initially to a gynecologist complaining of urinary incontinence and pelvic relaxation symptoms. Failure to appreciate the neurologic signs on physical examination may have led to a delay in diagnosis and inappropriate management of the patient.     

脊柱结核的CT表现

目的：探讨脊柱结核的CT表现。方法：对35例脊柱结核患者行CT扫描，其中有5例同时行增强扫描。结果：35例脊柱结核患者中，胸腰椎段结核18例(51．4％)；腰椎结核9例(25．7％)；胸椎结核5例(14．3％)；颈椎结核2例(5．7％)；骶椎结核1例(2．9％)。早期脊柱结核4例，仅见椎前软组织肿胀；进展期脊柱结核24例，可见椎体呈“融冰样”、“碎玻璃样”骨质破坏，破坏区内可见沙砾样死骨，增强后冷脓肿壁均一环状强化；愈合期脊柱结核7例。结论：脊柱结核在CT上有着典型的影像学表现，CT可对脊柱结核作出明确诊断。     

BRAIN ABSCESS DUE TO PSEUDOMONAS PSEUDOMALLEI

Abstract A brain abscess due to Pseudomonas pseudomallei is presented. Central nervous system involvement in melioidosis is rare and generally occurs in association with disseminated infection. The importance of early diagnosis and prompt treatment with prolonged antibiotic therapy is emphasised.     

Prevalence of symptomatic pelvic organ prolapse in a Swedish population

Our aim was to estimate the prevalence of symptomatic pelvic organ prolapse (POP) in a Swedish urban female population. The cross-sectional study design included 8,000 randomly selected female residents in Stockholm, 30–79-year old. A postal questionnaire enquired about symptomatic POP, using a validated set of five questions, and about urinary incontinence and demographic data. Of 5,489 women providing adequate information, 454 (8.3%, 95% confidence interval 7.3–9.1%) were classified as having symptomatic POP. The prevalence rose with increasing age but leveled off after age 60. In a logistic regression model that disentangled the independent effects, parity emerged as a considerably stronger risk factor than age. There was a ten-fold gradient in prevalence odds of POP with parity, the steepest slope (four-fold) being between nulliparous and primiparous women. The prevalence of frequent stress urinary incontinence was 8.9% and that of frequent urge incontinence 5.9%. Out of the 454 women with prolapse, 37.4% had either or both types of incontinence.