Objective To investigate the risk factors, diagnosis and treatment of solitary pulmonary nodule （diameter≤3cm）. Methods From Jan. 2001 to Dec. 2002, the clinical data of 297 patients with solitary pulmonary nodule were reviewed. Chi-square or t-test were used in univariate analysis of age, gender, symptom, smoking history, the size, location and radiological characteristics of nodule, and logistic regression in multivariate analysis. Results Univariate analysis revealed that malignancy was significantly associated with age （P=0. 000）, smoking history （P=0. 001）, the size （P=0. 000） and radiological characteristics （P=0. 000） of nodule. In multivariate analysis （logistic regression）, it was significantly associated with age （OR = 1. 096）, the size （OR = 2. 329） and radiological characteristics （OR=0. 167） of nodule. Conclusion Age and the size of nodule could be risk factors. Radiological findings could help distinguish from malignant nodules.
目的 探讨十二指肠良性肿瘤的诊断与治疗。方法 对1992~1998年间收治的10例患者的临床资料行回顾性总结分析。 结果术前经纤维十二指肠镜确诊7例 ，上消化道X线钡餐确诊3例。肿瘤位于十二指肠降部7例，球部3例。其中6例行手术治疗，4例因心肺脑等严重合并症行保守治疗。手术为十二指肠肿瘤局部切除连同周围肠壁组织部分切除。术后病理报告2例为平滑肌瘤，2例为布鲁氏纳氏腺瘤，2例为间质瘤。结论 十二指肠良性肿瘤可引发严重并发症，如出血、腹痛、肠梗阻、穿孔等，并约有15%的病例可发生恶变。一经诊断，应及早手术治疗，手术一般宜行局部切除。
目的:探讨胚胎发育不良性神经上皮肿瘤(DNT)的临床、影像及病理学特征、诊断及鉴别诊断.方法:回顾性分析8例胚胎发育不良性神经上皮肿瘤患者的临床和影像学资料,进行光镜和免疫组织化学染色观察,并获得6例的随访资料.结果:胚胎发育不良性神经上皮肿瘤男性7例,女性1例,年龄为5～19岁,平均年龄13岁,5例以癫痫小发作为主要临床表现,病变均位于幕上,以皮层为主,影像学检查均无明显的占位效应及瘤周水肿。肿瘤细胞主要由少突胶质样细胞(OLC)、神经元和星形细胞组成,4例伴有皮质发育不良。免疫组织化学结果为神经元及部分少突胶质样细胞呈嗜铬素A、突触素及S-100阳性表达;少突胶质样细胞呈胶质纤维酸性蛋白(GFAP)阴性表达,而星形细胞呈GFAP阳性表达;Ki-67抗原标记指数lt;1%。结论: 胚胎发育不良性神经上皮肿瘤为WHOⅠ级良性肿瘤,可结合临床、影像及病理学表现明确诊断,预后良好,无需放疗和化疗。
ObjectiveTo compare efficacy of laparoscopic or open hepatectomy in benign liver tumors patients with different difficult operations. MethodsAccording to the inclusion and exclusion criteria, the patients with benign liver tumors who underwent hepatectomy in the Affiliated Hospital of Xuzhou Medical University from September 2014 to March 2021 were collected. The enrolled patients were assigned into low, medium, and high difficulties by the Hasegawa liver resection surgical difficulty score model, then the patients were matched by propensity score matching. The liver function and inflammatory indexes, intraoperative bleeding, operative time, total hospital stay, postoperative complications, and hospitalization expenses of patients with benign liver tumors after laparoscopic (laparoscope group) or open (open group) hepatectomy were compared. ResultsA total of 209 patients who met the inclusion and exclusion criteria were enrolled in this study. According to the Hasegawa criteria, there were 59, 89, and 61 patients with low, medium, and high difficulties respectively. After 1∶1 propensity score matching, 18, 34, and 14 patients in the laparoscope group and open group were matched respectively. There were no statistic differences in the baseline data between the laparoscope group and open group (P>0.05). ① For the patients with low and medium difficulties, compared with the open group, the different values of alanine aminotransferase, aspartate aminotransferase, white blood cell count, and neutrophil percentage were lower (P<0.05), the intraoperative bleeding and total hospital stay were less or shorter (P<0.05), and the albumin were higher (P<0.05) in the laparoscope group. There were no statistic differences in these indexes among the patients with high difficulty (P>0.05). ② Compared with the open group, the operative time of the laparoscope group was shorter in the patients with low difficulty (P<0.05) and longer in the patients with high difficulty (P<0.05), and there was no statistic difference in patients with medium difficulty (P>0.05). ③ The postoperative complications had no statistic differences between the two groups for the patients with low and high difficulties (P>0.05), while which in the laparoscope group were lower than in the open group for the patients with medium difficulty (P<0.05). ④ The hospitalization expenses of the laparoscope group was higher than the open group for the patients with high difficulty (P<0.05), while which had no statistic differences between the two groups for the patients with low and medium difficulties (P>0.05). ⑤ The total hospital stay of the laparoscope group was shorter than the open group (P<0.05) no matter which difficult operation.ConclusionsAccording to results of this study, laparoscopic hepatectomy has more obvious advantages as compared with open hepatectomy for patients with low or medium difficulty, which could greatly shorten hospital stay and accelerate rehabilitation of patients. Even for patients with high difficulty, laparoscopic hepatectomy still shows an advantage of shortening hospital stay.
ObjectiesTo investigate the impact of family nursing intervention on the quality of life in postoperative patients with benign prostatic hyperplasia (BPH). MethodsIn total, 60 consecutive patients who underwent BPH surgeries between December 2012 and January 2014 were enrolled and randomly assigned to receive either timely outpatient follow-ups and routine rechecks (control group) or nursing intervention of telephone call follow-ups and family visits by professional nurses (intervention group). Quality of life was assessed by international prostate symptom score (IPSS) and generic quality of life inventory-74 (GQOLI-74), and was compared before and after intervention between the two groups. ResultsThere were no statistically significant differences in GQOLI-74 scores of all dimensions at discharge between the intervention group and the control group (P>0.05). However, six months after discharge, GQOLI-74 scores of all dimensions were significantly different between the two groups (P<0.05), and were also significantly different from the scores at discharge in both groups (P<0.05). At discharge, IPSS scores were not significantly different between the two groups (P>0.05). Six months after discharge, IPSS scores of the intervention group (6.33±1.03) and the control group (7.83±0.94) were significantly different (P<0.05), and were also significantly different from the scores at discharge in the intervention group (7.93±1.31) and the control group (8.10±1.06) (P<0.05). Three patients in the control group (10.0%) were admitted into the hospital again due to bleeding, while there was no bleeding case in the intervention group. No such complications as urethrostenosis or urinary incontinence occurred in both groups. Conclusion Family nursing intervention improves effectively the quality of life in postoperative patients after surgeries for benign prostatic hyperplasia.
With the aging of the population, the incidence of benign paroxysmal positional vertigo (BPPV) and osteoporosis have been increasing year by year, and the incidence of BPPV in vertigo related diseases has also been ranked first. There are similarities in structure, formation and metabolic mechanism between bone and otolith, but there is no consistent conclusion on the relationship between BPPV and osteoporosis. This article summarizes the current situation of the research on the correlation between BPPV and osteoporosis, the common risk factors and the related co-occurring mechanisms, aiming to provide more ideas for the prevention and treatment of BPPV patients, and improve the prevention and treatment ability of the co-diseases in the elderly.
Objective To assess the efficacy of finasteride in treating perioperative bleeding in patients undergoing transurethral resection of the prostate (TURP). Methods We searched MEDLINE (1966 to 2005), EMBase (1984 to 2004), CBM (1980 to 2005), The Cochrane Library (Issue 4, 2005) and relevant journals to identify cl inical trials involving finasteride in patients undergoing TURP. We also checked the references in the reports of each included trial. The qual ity of randomized controlled trials (RCTs) was assessed according to the methods recommended by The Cochrane Collaboration, and the qual ity of non-RCTs was assessed based on the methods recommended by Jiang-ping Liu, Stroup and Hailey. Two reviewers extracted data independently and data analyses were conducted with The Cochrane Collaboration’ s RevMan 4.2. Result We included 4 RCTs and 1 non-RCT. The qual ity of 3 RCTs was graded C and the other one was graded B. The quality of the non-RCT was relatively high. Meta-analyses showed that with comparable age, international prostate symptom score, prostate specific antigen, preoperative volume of prostate and excision volume between the two groups (Pgt;0.05), the perioperative bleeding volume (WMD –85.44, 95%CI –117.31 to –53.58), the bleeding volume per gram of resected prostate tissue (WMD –3.5, 95%CI –6.34 to –0.58) and hemoglobin reduction (WMD –1.61, 95%CI –1.96 to –1.26) of the finasteride group were significantly smaller than those of the control group. Conclusion The evidence currently available indicates that preoperative use of finasteride may reduce bleeding in patients undergoing TURP.
目的 探讨前列腺体积＞60 mL的前列腺增生症患者的手术安全性，提高部分合并尿道狭窄前列腺增生症患者的手术实施率。 方法 2009年3月－2010年3月，行耻骨上膀胱穿刺引流下经尿道前列腺电切术（TURP）治疗前列腺增生58例。年龄54～93岁，平均72岁，病程8个月～12年，平均7.2年；前列腺体积35～128 mL，平均78 mL；国际前列腺症状评分24～35分，平均30.2分 ；最大尿流率1.2～4.8 mL/s，平均1.8 mL/s；残余尿量84～210 mL，平均160 mL。术前无尿潴留28例。 结果 58例顺利完成手术，其中2例伴包膜穿孔，9例前尿道狭窄者通过去外鞘电切镜完成手术。所有患者切除前列腺组织体积18～86 mL，平均58 mL；术中冲洗液为5%葡萄糖液，用量18 600～42 500 mL，平均23 500 mL；手术时间45～185 min，平均70 min。术后病理检查均示良性前列腺增生，术后住院时间3～8 d，平均5 d。术后患者最大尿流率为18～46 mL/s，平均32 mL/s。 结论 耻骨上膀胱穿刺引流能降低膀胱内压，减少水、糖分吸收，增加手术安全性，提高了部分合并前尿道狭窄的前列腺增生患者的手术几率。