Objective To summarize the clinical features of lymphangioleiomyomatosis ( LAM) in Chinese population. Methods The first case of LAM in China was reported in 1981. All cases of LAM reported in Chinese literature from January 1981 to December 2009 were reviewed. The cases for analysis were included with a diagnosis of LAM confirmed or probable according to the guidelines of European Respiratory Society, and with individual clinical data available. Results A total of 111 cases of LAM werepooled for analysis. All cases were female. The most frequent onset symptomof LAMwas dyspnea ( 51. 4% ) .The main clinical manifestations included dyspnea ( 93. 4% ) , pneumothorax ( 48. 6% ) , cough ( 45. 7% ) ,hemoptysis ( 35. 1% ) , and chylothorax ( 33. 3% ) . 11 cases were associated with tuberous sclerosis complex.An obstructive with or without restrictive abnormality in pulmonary function testing was observed in 60 /67 cases. Diffusion impairment was also common ( 45 /46) . Of the 109 patients, computerized tomography of chest showed thin-walled air-filled cysts throughout both lungs in 104 cases, multiple bullae in 3 cases, andhoneycomb changes in 2 cases. 102 cases were diagnosed based on pathological findings. Misdiagnosis was found in 44 cases, the median time of misdiagnosis was 24 months. Conclusion Awareness of LAMshould be raised when an adult female who presents with an unexplained dyspnea, especially combined with repeatedpneumothorax or chylothorax.
目的 探讨十二指肠球部远端溃疡的诊断和选择合适的手术治疗。方法 对我院25例十二指肠球部远端溃疡的临床资料进行了分析。结果 术前行上消化道X线钡餐检查8例，提示十二指肠球部溃疡4例，幽门梗阻2例； 纤维胃镜检查9例，发现十二指肠球部远端溃疡7例。术前确诊7例，误诊18例。20例曾行非手术治疗，但效果差，并出现溃疡并发症，如出血、穿孔、梗阻性黄疸、胆囊内瘘、幽门梗阻、急性胰腺炎等。本次手术治愈25例，1例术后9天并发输入、输出襻粘连性肠梗阻，经再次手术而愈。结论 纤维胃镜检查是诊断本病的主要方法，手术是该病的重要治疗措施。
目的总结十二指肠损伤的诊断和治疗经验。方法对我院1989年1月至2003年7月期间收治的13例十二指肠损伤患者的临床资料进行回顾性分析。本组均经手术治疗，行十二指肠单纯修补术6例，十二指肠憩室化手术1例，改良憩室化术4例（3例缝扎十二指肠），Roux-en-Y吻合术1例，T管引流及脓肿切开引流术1例。结果治愈11例； 死亡2例, 其中1例死于十二指肠瘘，另1例死于肝功能不全。结论十二指肠损伤的早期诊断和手术处理非常重要； 缝扎十二指肠的改良憩室化手术是治疗重症十二指肠损伤的一种较理想术式。
目的:探索早期乳腺癌的临床特点和诊断方法。方法:回顾性分析46例早期乳腺癌的临床资料。结果:46例患者中表现为乳腺痛及肿块者30例,以乳房肿块就诊者16例。钼靶照片14例,诊断为乳腺癌5例(35.7%)。42例作彩色超声检查,发现不规则低回声结节37例(89.0％),部分肿块内可见点状强回声,周围有蟹足状,血流增加。细针穿刺细胞学检查40例,23例发现癌细胞,直接住院,术中冰冻切片决定手术方式;23例门诊先行切除活检后住院治疗。结论:高危妇女表现为乳腺增生,用药不好转、症状加重者,应怀疑乳腺癌,首选彩色超声检查,诊断价值优于钼靶照片。有肿块者结合穿刺细胞学检查,可提高早期乳腺癌的诊断率。
Objective To study the characteristics of optic al coherence tomography (OCT) in idiopathic macular epiretinal membranes (IMEM) and the relationship between the thickness of fovea and the vision of affected eyes. Methods Total of 67 cases (73 eyes) with clinica l diagnosis of IMEM by direct, indirect ophthalmoscopy, three mirror contact len s, fundus color photography or fundus fluorescein angiography(FFA）were examined with OCT. Results Epiretinal membranes(ERMs) with macular edema were found in 32 eyes, proliferative ERMs in 20 eyes, ERMs with macular pseudoholes in 14 eyes and ERMs with laminar macular holes in 7 eyes. Based on OCT, the ERMs were clearly and partially seperated from the retina (27 eyes, 38.36%), the retinal thickness of the fovea was the thickest in proliferative ERMs and the thinnest in ERMs with laminar macular holes. The statistical an alysis showed there was a negative correlation between the thickness of fovea an d visual acuity (r=－0.454, P= 0.000 ). Conclusion There were four types of image of OCT in IMEM: ERMs with macularedema, proliferative ERMs, ERMs with macular pseudohole and ERMs with laminar macular hole；and the thicker the fovea under the OCT, the poorer th e visual acnity in the affected eyes with ERMs. (Chin J Ocul Fundus Dis, 2001,17:115-118)
【摘要】 目的 探讨多尿性梗阻性肾衰的诊断和治疗。 方法 回顾性分析2004年5月-2007年5月收治的15例多尿性梗阻性肾衰患者的临床资料。 结果 经治疗后15例患者肾功能均恢复正常。 结论 多尿性梗阻性肾衰的治疗关键在于诊断，诊断明确后可以用各种方法解除功能性孤立肾的梗阻，挽救肾脏功能。【Abstract】 Objective To investigate clinical experience of the diagnosis and therapy for the hyperdiuresis post-renal acute renal failure. Methods Clinical data of 15 patients with hyperdiuresis post-renal acute renal failure admitted from May 2004 to May 2007 were retrospectively analyzed. Results All of the patients were treated successfully without death and complications. Conclusion The core for the treatment of hyperdiuresis post-renal acute renal failure is the diagnosis. Several therapies can be used to relieve obstruction and save renal function after precise diagnosis.
目的 探讨原发性脑淋巴瘤的MRI表现及病理基础，提高对脑原发性淋巴瘤的认识。 方法 回顾分析2010年1月－2012年5月28例确诊为脑原发性淋巴瘤的MRI影像特征及临床病理资料。 结果 28例患者，共发现36个病灶，幕上病灶34个，幕下病灶2个；MRI平扫；32个病灶在T1WI、T2WI肿瘤实质表现为等信号；4个病灶内出现液化坏死（其中1个病灶呈明显囊变），信号不均。MRI增强扫描：35个肿瘤病灶实质部分均匀强化，1个病灶呈环形强化。病理类型均为弥漫性大B细胞非霍奇金淋巴瘤。 结论 原发性脑淋巴瘤具有较典型的MRI影像特征，可在术前明确诊断。