经尿道前列腺等离子电切术联合药物对BPH合并CP的疗效

目的探讨经尿道前列腺等离子电切术(PKRP)联合药物治疗对良性前列腺增生(BPH)并慢性前列腺炎(CP)的临床疗效。方法选取2013年6月~2014年6月于我院接受治疗的60例BPH合并CP患者作为研究对象,所有患者均使用经尿道前列腺等离子电切术联合α-受体阻滞剂进行治疗,观察患者术前、术后各观察指标变化情况。结果 60例患者平均手术时间(52.4±10.8)min,平均出血量和平均住院时间分别为(74.7±20.5)ml、(6.0±3.1)d,患者术后并无尿道穿孔、外渗、尿失禁等并发症。随访3个月,患者的IPSS、QOL、RUV各个评分低于治疗前,Qmax评分高于治疗前,P0.05,差异具有统计学意义。结论经尿道前列腺等离子电切术(PKRP)联合药物治疗BPH合并CP患者,具有操作简单、安全等特点,能有效缓解患者排尿困难、尿路梗阻的问题,改善其生活质量。     

Extraskeletal neuroectodermal tumour of the vagina: a single case report and review

Abstract  A case report and review of an extraskeletal neuroectodermal tumour of the vagina. Background  Ewing’s sarcoma (ES) and primitive neuroectodermal tumours (PNETs) account for approximately 6–10% of primary malignant bone tumours and, following osteosarcoma, are the second most common group of bone sarcomas in children. Ewing’s sarcoma rarely affects the genitourinary tract. Case summary  We report a rare case of extraskeletal Ewing’s sarcoma diagnosed in a 47-year-old Indian woman presenting with a simple cystic lesion in the posterior wall of the vagina. The histopathology revealed a rare presentation of a primitive malignant extraskeletal neuroectodermal tumour. Conclusion  As our PubMed review found only six previously reported cases of vaginal extraskeletal Ewing’s sarcoma. Presentation as vaginal masses helped in early disease detection.     

A nonfunctioning islet cell carcinoma with tumor thrombus in both the portal and splenic veins — a case report of successful resection

A rare case of nonfunctioning islet cell carcinoma associated with tumor thrombi in both the portal and splenic veins is reported. The patient, a 49-year-old male, had a 2-year history of occasional abdominal pain. Computed tomography (CT) disclosed a huge mass in the body of the pancreas, and celiac arteriogram showed a tumor stain in the body and tail of the pancreas. Percutaneous transhepatic portography (PTP) demonstrated an irregular filling defect, indicating intraportal tumor growth. Curative surgery, which included total pancreatectomy with combined resection (50 mm in length) and reconstruction of the portal vein, distal gastrectomy, and partial resection of the transverse colon, was performed. Histological examination of the surgical specimen led to a diagnosis of nonfunctioning islet cell carcinoma with a negative immunohistochemical stain for insulin, glucagon, somatostatin, and adrenocorticotropic hormone. The patient has been well for 38 months to date without any sign of tumor recurrence. Our experience with this case has introduced a radical resection for islet cell tumor of the pancreas, even if the tumor has extended into the portal vein.     

Suppressive effect of acetylcholine on automaticity of cannine atrioventricular node

The effects of acetylcholine on the spontaneous activity of the AV node of dog hearts were studied by recording transmembrane potentials of its fibers. Action potentials of most nodal fibers were characterized by prominent phase 4 depolarization and a smooth transition from phases 4 to 0. On the isolated AV nodes, acetylcholine at 1.0 μg/m1 suppressed the rate of phase 4 depolarization and increased the amplitude of the maximum diastolic potential, resulting in a slowing of spontaneous activity. At 2.0 μg/m1, spontaneous activity was completely suppressed. In comparison, spontaneous activity of the isolated His bundle was relatively insensitive to the suppressive effect of acetylcholine at the same concentrations. In the AV node-His bundle preparations in which the AV node was the pacemaker, acetylcholine decreased spontaneous activity by suppressing the phase 4 depolarization of the nodal fibers and shifted the pacemaker of the preparation to the His bundle. The findings provide a basis for predicting that under strong vagal influence, the automaticity of the AV node will be suppressed and the pacemaker of the junctional rhythm will be located at the His bundle.     

肾脏透明细胞癌的病理诊断分析

目的：探讨肾脏透明细胞癌的病理诊断分析。方法整群选取2011年1月-2014年6月在该病理科进行肾脏透明细胞癌的病理诊断的163例患者作为研究对象,并对其病理资料进行回顾性分析。结果163例患者中,肾透明细胞癌玉级56例,占34.4%,肾透明细胞癌Ⅱ级43例,占26.4%,肾透明细胞芋级35例,占21.5%,肾透明细胞癌Ⅳ级29例,占17.7%。镜下可见肿瘤细胞体积较大,圆形或多边形,胞质丰富,透明状,间质富有毛细血管和血窦。结论病理诊断是在镜下观察组织结构和细胞病变特征而做出的疾病诊断,肾脏透明细胞癌是肾癌中最常见的恶性肿瘤,预后较好,及早进行病理诊断分析,可以大大的提高患者的生活质量。     

鼻内镜下下鼻甲粘膜下吸切术治疗肥厚性鼻炎疗效分析

目的：分析鼻内镜下下鼻甲粘膜下吸切术治疗肥厚性鼻炎的疗效。方法回顾2012年1月—2013年6月该院收治的100例肥厚性鼻炎患者的临床资料,根据手术方法的不同将患者分成对照组和观察组,各50例。对照组采用下鼻甲部分切除术治疗,观察组采用鼻内镜下下鼻甲粘膜下成形术治疗,比较两组手术时间、术中出血量、粘膜恢复时间、鼻腔通气时间以及术后半年的疗效和并发症发生率。结果两组术中出血量、粘膜恢复时间、鼻腔通气时间以及术后半年的疗效比较,差异有统计学意义（P＜0.05）,且观察组优于对照组,但观察组的手术时间较对照组长,差异有统计学意义（P＜0.05）;两组均无并发症发生。结论采用鼻内镜下下鼻甲粘膜下成形术治疗肥厚性鼻炎,术中出血量和术后并发症少,安全性高,且患者恢复快,临床疗效良好,具有推广应用价值,但手术时间较长,技术上有待提高。     

胃肠胰神经内分泌肿瘤临床病理特征及预后分析

目的 分析胃肠胰神经内分泌肿瘤的临床及病理特点。 方法 收集本院病理诊断为胃肠胰神经内分泌肿瘤的病例15例,按照2010年第4版《WHO消化系统肿瘤分类》标准进行病理复核,回顾分析其临床资料,总结其临床及病理特点。 结果 15例胃肠胰神经内分泌肿瘤中,中位发病年龄为56岁。发病部位多见于食管,其次为胰腺,CgA阳性率为73%,Syn阳性率为87%,分期为IV期及病理分级为3级的患者预后差。 结论 胃肠胰神经内分泌肿瘤具有很高的异质性,临床分期及分级是主要的预后因素,早期诊断及治疗可改善患者预后。