应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

A CLINICAL STUDY ON PROSTATE CANCER DIAGNOSIS WITH cDNA MACROARRAY

Objective: To diagnose prostatic cancer (CAP) with cDNA macroarray. Methods: Total RNA was isolated from patients with prostate cancer and from normal people, and poly(A) RNA was further purified. Then differentially expressed genes were analysed in CaP and normal prostate by cDNA macroarray system. Results: There were differential expressions of nine prostate-associated specific genes in CaP as compared with normal prostate, among which, 7 were significantly up-regulated and 2 were down-regulated. Conclusion: As a diagnostic approach at molecular level, the cDNA macroarray is supposed to elevate the detection rate of CaP.     

知己·朋友·熟人

有、了高兴事，我找人分享。第一个人比我还高兴，第三个人流露出羡慕的神情，第三个人努力伪装出平一静，内心却波澜起伏，恨不能让我的高兴瞬间化成轻风。有了烦恼事，我找人倾诉。第一个人为我不该受一耕的委屈必愤填膺，第二个人不为所动，开始絮絮叨叨说’自己的事情；第三个人尽量抑制，也没抑制住那种幸，灾乐祸的表情。     

群组管理对老年前列腺术后患者下肢活动依从性的影响

目的探讨群组管理对老年前列腺术后患者下肢活动依从性的效果。方法将60例患者分为干预组和对照组,对照组按常规护理,干预组实施1周的群组管理活动。结果干预后干预组患者对预防DVT发生的知晓度、进行下肢主动活动的依从性高于对照组,双下肢皮肤温度、颜色、胀痛等改变显著小于对照组,比较差异均有统计学意义(P<0.01)。结论群组管理是一种有效的管理模式,可增强患者的自我效能,提高患者下肢活动的依从性,达到预防DVT发生的作用。     

非侵袭性检查指标对中老年男性膀胱出口梗阻的诊断价值

目的：探讨临床常用非侵袭性检查指标诊断膀胱出口梗阻（BOO）的准确性及可靠性。方法回顾性研究2003年11月—2015年11月在广州市第一人民医院就诊并接受压力—流率测定（PFS）的男性 LUTS ／BPH患者,以侵袭性的 PFS 为诊断 BOO 的“金标准”,以前列腺体积（PV）、移行带体积（TZV）、移行带指数（TZI）、前列腺特异性抗原（PSA）、最大尿流率（Qmax）、剩余尿量（PVR）、剩余分数（RF）等非侵袭性检查指标为诊断指标进行诊断试验评价。结果筛选1319例患者纳入统计分析。以 ICS 列线图为诊断标准,PV、TZV、TZI、PSA、Qmax、RF、PVR 诊断 BOO 的 ROC 曲线下面积（AUC）分别为0．803、0．807、0．698、0．775、0．740、0．679、0．641;以 Schaefer 列线图为诊断标准,PV、TZV、TZI、PSA、Qmax、RF、PVR 诊断 BOO 的 AUC 分别为0．806、0．814、0．713、0．773、0．721、0．684、0．642。结论 PV、TZV、TZI、PSA、Qmax、RF、PVR 等非侵袭性指标对筛查及诊断中老年男性 BOO 有一定的参考价值及临床意义,其中 TZV、PV、PSA、Qmax 的诊断准确性较高。     

PSA密度在PSA 2.5～10.0 ng/mL和10.1～20.0 ng/mL患者前列腺癌诊断价值的多中心研究

目的探讨前列腺特异性抗原密度(PSAD)在前列腺特异性抗原(PSA)值位于2.5~10 ng/m L和10.1~20.0 ng/m L患者前列腺癌诊断的效能。方法回顾性分析广州地区两家医院中PSA在2.5~20.0 ng/m L之间,行经直肠前列腺体积测量并行前列腺穿刺的461名患者临床资料,入选者分为PSA 2.5~10.0 ng/m L和PSA10.1~20.0 ng/m L两组,通过受试者工作特征曲线(ROC)分析法评价PSAD与PSA在预测前列腺癌的诊断效力。结果 PSA 2.5~10.0 ng/m L和PSA 10.1~20.0 ng/ml两组的曲线下面积比较,PSAD均高于PSA。在PSA 2.5~10.0 ng/m L组,PSAD预测前列腺癌的最佳临界点为0.15 ng·m L~(-1)·m L~(-1),敏感性和特异性分别为64.4%和64.6%;在PSA10.1~20.0 ng/m L组,PSAD预测前列腺癌的最佳临界点为0.33 ng·m L~(-1)·m L~(-1),敏感性和特异性分别为60.3%和82.7%。结论对于PSA2.5~10.0 ng/m L和10.1~20.0 ng/m L的中国男性,PSAD是一种更优的前列腺癌预测指标。     

膀胱灌注感觉神经阻滞剂预防前列腺术后患者膀胱痉挛的疗效观察及护理

目的探讨膀胱灌注感觉神经阻滞剂（RTX）预防前列腺术后膀胱痉挛的疗效及有效护理措施。方法按住院顺序选择良性前列腺增生拟行耻骨上前列腺切除术患者20例，随机分为对照组和观察组各10例。观察组患者术前3d向膀胱灌注RTX原液4ml＋生理盐水100ml；对照组患者术前3d向膀胱灌注生理盐水104ml。术后观察记录2组拔除导尿管和膀胱造瘘管前膀胱痉挛的频率、强度（疼痛视觉模拟评分，VAS）、持续时间，膀胱冲洗液颜色转清时间，拔除导尿管和膀胱造瘘管后1，2,4周的国际前列腺症状评分及生活质量评分。结果观察组与对照组患者术后膀胱痉挛发生率分别为20％和80％。冲洗液转清时间分别为（2．8±1．7）d和（5．2±1．0）d，造瘘管留置时间为（4．0±1．6）d和（5．8±1．1）d，导尿管留置时间为（913±1．3）d和（11．8±1．1）d，VAS为（2．3±1．3）分和（4．6±1．1）分，差异均有统计学意义（P〈0．05）。观察组与对照组患者拔除导尿管和膀胱造瘘管1,2,4周后的国际前列腺症状评分分别为（11．1±3．3）分和（16．0±3.0）分，（9．5±14）分和（12．7±3．2）分，（84±1．6）分和（11．3±2．7）分，差异均有统计学意义（P〈0．05）。观察组与对照组患者拔除导尿管和膀胱造瘘管4周后的生活质量评分分别为（1．6±0．5）分和（Z8±0.9）分，差异有统计学意义（P〈0．01）。结论术前膀胱灌注RTX能降低前列腺术后膀胱痉挛的发生率和严重程度。规范化膀胱灌注及严密病情观察，保持术后膀胱冲洗通畅是使RTX灌注发挥最大疗效的重要护理措施。     

肾上腺节细胞神经瘤3例报告

目的:探讨肾上腺节细胞神经瘤的病因病理、临床症状及诊断治疗。方法:报告3例肾上腺节细胞神经瘤的临床资料,2例经右11肋间切口行右肾上腺切除术,1例经腹行左肾根治性切除术。结果:术后生存良好,分别随访89、48和10个月,均未发现肿瘤复发和转移。结论:肾上腺节细胞神经瘤是一种罕见的良性肿瘤,多数临床症状不明显,B超显示实质性包块,回声均匀,回声强度与肝脾实质相似;CT显示圆形或类圆形实质性包块,密度低于肌肉,增强后有轻度强化,并可有轻度的非均质性;手术切除是其主要的治疗方法,多数预后良好     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.