小儿上尿路结石286例临床分析

目的:进一步探讨新疆地区小儿泌尿系结石的临床特征.方法:对收治的286例小儿上尿路结石患儿的临床资料进行分析.其有明显的区域、族群分布和结石成分特征;均经影像学确诊;239例行开放手术取石治疗.结果:开放手术取石239例,一次取尽结石率89.0%,术后2～12年复发41(14.3%)例,术中术后未发现严重并发症.结论:影像学检查是诊断小儿泌尿系结石的主要手段,磁共振尿路成像对小儿尿路结石形态诊断,具有较好的实用性和优越性;开放手术适应证广、技术成熟,仍是目前小儿泌尿系结石的主要治疗方法.     

Intravesical migration of intrauterine device resulting in pregnancy

Spontaneous migration of an intrauterine device into the bladder is very rare. A 29-year-old woman in whom an intrauterine device had been placed 6 years previously, presented complaining of chronic pelvic pain and recurrent irritative urinary tract symptoms. One year after insertion she had became pregnant and given birth without complications. Intravesical migration of the intrauterine device was confirmed by sonography and cystoscopy. The intrauterine device was removed by suprapubic cystostomy.     

腺性膀胱炎的治疗(附33例报告)

目的　探讨腺性膀胱炎的诊断和治疗。方法　对33例腺性膀胱炎患者行经尿道电切汽化术及膀胱药物灌注治疗。 结果　33例均获随访6～38个月,平均22个月,其中治愈30例,3例6～12个月内复发。结论　经尿道电切汽化加膀胱药物 灌注是治疗腺性膀胱炎的首选方法,该法既可以消除临床症状,又可以预防复发和恶变。     

Antegrade extraperitoneal approach to radical cystectomy and ileal neobladder

BACKGROUND: We describe a new operative technique for the surgical treatment of bladder cancer. METHODS: Male patients with invasive bladder cancer were managed by radical cystoprostatectomy using a technically different approach than the conventional method. The main feature of this method includes a small vertical incision between pubis and umbilicus, keeping the abdominal peritoneum closed during the surgery. Reperitonealization is done at completion to isolate the urinary anastomoses from the bowel anastomoses. RESULTS: Seventy-six consecutive patients with bladder cancer underwent this operation. The mean operation time was 4 h 30 min and the mean hospital stay was 11 days. No mortality was seen in the early postoperative period. Only one patient developed serious bowel distension. Two patients developed pneumonia. Wound infection was seen in two patients. Two patients experienced hydronephrosis in the late period of follow-up. Four patients developed pelvic lymphocele. There was no evidence of postoperative electrolyte loss in any of the patients. Three patients developed abdominal hernia and this was corrected with surgical treatment. Urodynamic evaluation of 15 patients showed a low capacity reservoir. All patients were continent during the daytime. CONCLUSION: This technique keeps the abdominal peritoneum closed during radical cystoprostatectomy, preventing the patients from complications, such as infection, water and electrolyte imbalances. The technique also decreases the recovery time.     

微波组织凝固器在无阻断肾蒂肾部分切除术中的应用

目的探讨微波组织凝固器在无阻断肾蒂肾脏部分切除术中应用价值。方法用微波组织凝固器对16例(17个肾脏)行肾脏部分切除术,术中未阻断肾蒂。结果1例同时行双侧肾部分切除术患者手术时间为325min,15例手术时间为90~220min,平均为180min。术中出血量45~450ml,平均80ml。术前术后血肌酐无显著性差异。患者术后第2天即可下床活动。结论微波组织凝固器在肾脏部分切除术中,具有微创、安全、出血少及操作简便等作用。     

The relationship between cocaine-induced paranoia and compulsive foraging: a preliminary report

Two prominent behavioral syndromes associated with chronic cocaine use that have been described in the literature are cocaine-induced paranoia (CIP) and cocaine-induced compulsive foraging (CICF) for cocaine. To help to clarify the relationship between the two cocaine-induced syndromes, the concordance and sequence of onset of the two cocaine-induced behaviors over the course of the patients' lifetime use of cocaine and during the course of a binge was examined in 62 crack cocaine-dependent men. Winy-four (54.8%) reported experiencing both CIP and CICF. In 18 (29%) of the patients, only one of these cocaine-induced behavioral syndromes was reported. Ten (16.1%) of the subjects reported neither CIP nor CICF. Patterns of cocaine or other substance use and degrees of tolerance to cocaine were not significantly different between the groups endorsing different patterns of cocaine-induced behaviors. CIP typically preceded the onset of CICF both over the course of the patients' lifetime use of cocaine and over the course of a binge. The study results suggest varying thresholds for the expression of these behaviors in chronic cocaine-abusing individuals.     

478例小儿低位隐睾治疗方式选择及疗效分析

目的：进一步探讨小儿低位隐睾的临床特点和治疗方式。方法：回顾性分析2008年10月至2014年10月间首次在我院泌尿外科接受治疗的478例(573侧)低位隐睾患儿的临床资料，根据年龄大小分别采用内分泌治疗(A组)和手术治疗(B组)，比较小儿低位隐睾在运用不同治疗方式后睾丸降入阴囊的成功率、睾丸萎缩或回缩的发生率及围手术期并发症的情况。结果：A组158例(198侧)睾丸降入阴囊的总成功率为38.4%(76/198)，其中A1组(0.5~1.0岁)成功率为53.6%(52/97)，A2组(1.0~2.0岁)成功率为23.8%(24/101)，差异有统计学意义(P<0.01)，随访期内未出现睾丸萎缩，睾丸回缩发生率分别为3.8%(2/52)和8.3%(2/24)，差异有统计学意义(P<0.05)。B组320例(375侧)采用三种术式，其中B1组(经腹股沟法)175例(198侧)、B2组(经阴囊法)87例(99侧)、B3组(经腹腔镜法)58例(78侧)睾丸降人阴囊的成功率均为100%，术后随访期内睾丸均未发生萎缩，睾丸回缩发生率分别为1.5%(3/198)、2.0%(2/99)、0%(0/78)，差异无统计学意义(P>0.05)；围手术期并发症发生率分别为2.5%(5/198)、1.0%(1/99)、1.3%(1/78)，差异无统计学意义(P>0.05)。结论：首次接受治疗且年龄小于1岁的低位隐睾患儿，应首选试用内分泌治疗；年龄大于1岁低位隐睾患儿，应首选经阴囊隐睾下降固定术。     

Anxiety and pupil reactivity in cocaine dependent subjects endorsing cocaine-induced paranoia: preliminary report

There has been the clinical impression that people with higher levels of anxiety and central arousal are more prone to develop cocaine-induced paranoia (CIP), but this notion has not been formally studied. In the current study, we examined the differences between 28 CIP-endorsing and 16 CIP-denying chronic cocaine users in their levels of state and trait anxiety as measured by the Spielberger State-Tail Anxiety Inventory. We also studied levels of central arousal and reactivity using pupil size measures both during exposure to neutral, abstract, non-drug cues, and after exposure to a cocaine cue. Levels of trait (but not state) anxiety were significantly higher in the CIP group than in the non-CIP group. Moreover, while there were no significant pupil size differences or changes between the two groups while viewing neutral, abstract video images, the CIP group had significantly greater pupillary dilation in response to a video image of crack cocaine than did the non-CIP group. These significant differences remained even after covarying for anxiety scores. The study findings seem relevant to studies of autonomic reactivity in response to drug cues in cocaine-dependent patients; such studies might remain attentive to potential cue reactivity differences between patients endorsing and those denying CIP. Finally, this is the first study showing higher trait anxiety in patients with CIP.