在膀胱肿瘤并发前列腺增生症患者中采用同次施行膀胱肿瘤切除术和保留尿道粘膜前列腺切除术探讨

目的 探讨膀胱肿瘤并前列腺增生症患者同期施行膀胱肿瘤切除术和保留尿道粘膜前列腺切除术的可行性.方法 对同期施行经尿道膀胱肿瘤切除术及保留尿道粘膜前列腺切除术的16例膀胱癌合并前列腺增生症患者的临床资料进行了回顾性分析.结果 该组患者均顺利康复,无明显合并症,术后复诊,随访时间2～4年,3例出现肿瘤复发.结论 同期施行膀胱肿瘤切除术和保留尿道粘膜前列腺切除术,安全、效果肯定,值得基层医院推广应用.     

Structural shielding design for a gamma ray stereotactic body radiotherapy system.

An OUR-QGD gamma ray stereotactic body radiotherapy system (body knife), made in China, is described. According to its structure and the principle of gamma radiation revolved on a focus, the energy distribution of scattered radiation in its treatment room is calculated. The structural shielding of the wall, roof, and door for a certain treatment room is calculated according to the local radiation protection law.     

004Topical Zinc Oxide for Open Pilonidal Wounds

Extended healing time and lack of documented effective treatments of sacrococcygeal pilonidal disease create substantial problems. Locally applied zinc oxide has been reported to promote wound healing. We have compared topical zinc oxide (3%) with placebo meshes for pilonidal wounds healing by secondary intention in a randomized, double‐blind, placebo‐controlled multicenter trial. Sixty‐four consecutive patients, 53 males, aged between 18 and 60 years (median 26 years) with excised pilonidal wounds were centrally randomized to local zinc oxide (30 mg/g, n = 33) or to placebo (n = 31) mesh treatment. Patients were followed with strict recording of beneficial and harmful effects. The median healing times were 54 days (42–71 days, interquartile range, n = 33) for the zinc group and 62 days (55–82 days, n = 31) for the placebo group. This difference was not statistically different (p = 0.32). Based on Cox regression analysis initial wound volume influenced healing negatively (p = 0.016) while smoking (p = 0.011) was associated with faster wound healing. Significantly (p < 0.01) more placebo (n = 12) than zinc oxide‐treated patients (n = 3) needed antibiotics postoperatively. Although topical zinc oxide increased (p < 0.001) wound fluid zinc levels (1830 ± 405 μM, mean ± SEM) compared with placebo (3.1 ± 1.6 μM) serum‐zinc levels did not differ significantly between the zinc (13.5 ± 0.4 μM) and placebo (12.8 ± 0.4 μm) groups on postoperative day 7. No adverse events were recorded. Topical zinc oxide treatment did not accelerate time to closure of open pilonidal wounds but was associated with reduced antibiotic usage.     

喷发胶所致酒精中毒

一位有酒精依赖病史的61岁老年女性因酒精中毒被送到急诊科，其血浆酒精浓度为322mg／dl。她承认因为发胶中非自然的的酒精成分，她混水应用了一瓶14盎司的发胶。最初她在参加一次酒精匿名会议时学会了这种应用非饮料酒精的方法，为了向家人隐瞒滥用酒精的事实，她开始应用并持续了数年。她应用的发胶的非自然酒精含量高达50％．其吸收量约为7盎司酒精，相当于141．25盎司80标准强度的酒精饮料。     

Preterm delivery and its risk factors]

A case-control study on preterm delivery was conducted in Jianan and Jianhan District, Wuhan City in 1988. 130 singleton preterm infants were included with 260 term infants as control. The results showed that the risk factors in prematurity were edema-proteinuria-hypertension syndrome (OR 1.8), maternal diseases in pregnancy (OR 1.6), hyperemesis gravidarum (OR 5.1), vaginal bleeding during pregnancy (OR 2.4), premature rupture of membranes (OR 3.6), low weight gain and low average weight gain per week during pregnancy, psychosocial stress during pregnancy, inadequate prenatal care, maternal stature less than 158 cm (OR 1.7), menarche before age 12 (OR 4.3), multi-gravida (OR 2.1), previous induced abortion (OR 2.1) and passive cigarette smoking during pregnancy. The author suggests that early treatment of complications of pregnancy and forcing prenatal care should be emphasized in order to reduce the incidence of preterm births.     

Inhibitory actions of serotonin on glutamate release in dorsal medulla suppress systemic arterial pressure of cats

The role of serotonin and glutamate release in dorsal medulla (DM) for regulation of systemic arterial pressure (SAP) was examined with microdialysis and high performance liquid chromatograph in anesthetized cats. KCl-perfusion in DM increased serotonin and glutamate concentrations in DM. Perfusion of serotonin resulted in decreases in glutamate concentration and SAP. Perfusion of alaproclate, a serotonin reuptake inhibitor that produced an increase in serotonin concentration in DM, had the same results as perfusion of serotonin. In conclusion, serotonin and glutamate appeared to be tonically and endogenously released from nerve terminals in DM, and the decrease in SAP could be attributed to the decreased glutamate release resulting from inhibitory action of serotonin in DM. The putative roles of serotonin and glutamate in DM may be important in SAP regulation.