Search

Treatment of Acute Renal Failure Induced by Upper Ureteric Obstruction with Ureterorenoscope

目的:探討急性上尿路梗阻性腎功能衰竭的治療方法。方法:采用輸尿管鏡檢查,酌情鈥激光碎石,放置雙J管內引流治療32例急性上尿路梗阻性腎功能衰竭患者。結果:術后患者血清BUN、SCr均明顯下降,尿量不同程度恢復,結石排凈率90.6%(29/32)。結論:對于上尿路結石梗阻性急性腎功能衰竭的患者,急診輸尿管鏡下鈥激光碎石,療效確切,創傷小,可同時處理雙側輸尿管結石。

A Meta-analysis of Capacitance Combined with Irinotecan versus Fluorouracil Combined with Irinotecan for Advanced Metastatic Colorectal Cancer

ObjectiveTo assess the effectiveness and safety of capacitance combined with irinotecan (CAPIRI) versus fluorouracil combined with irinotecan (FOLFIRI) for patients with advanced metastatic colorectal cancer. MethodsDatabases such as Pubmed, Embase, Wanfang data, CNKI, Cochran Library were searched from January 2000 to October 2015. We evaluated the quality of randomized controlled trials (RCTs) and then extracted data from them. RevMan 5.2 software was used to perform the meta-analysis. ResultsEight RCTs studies with 1 634 advanced metastatic colorectal cancer patients were included based on our standard. CAPIRI regimen was equal to FOLFIRI regimen in complete response rate [RR=1.17, 95%CI (0.70, 1.96), P=0.56], overall respond rate [RR=0.90, 95%CI (0.79, 1.03), P=0.12], disease control rate [RR=0.93, 95%CI (0.87, 1.00), P=0.06], median progression-free survival [HR=1.00, 95%CI (0.72, 1.37), P=0.99], and median overall survival [HR=0.94, 95%CI (0.63, 1.40), P=0.77]. For safety, higher incidence rate of grade 3/4 vomiting [RR=1.91, 95%CI (1.13, 3.22), P=0.02], diarrhea [RR=2.84, 95%CI (2.22, 3.63), P<0.000 01], hand-foot syndrome [RR=4.55, 95%CI (2.15, 9.61), P<0.000 1] were confirmed for CAPIRI. The two methods had similar toxicities: nausea [RR=0.77, 95%CI (0.64, 0.93), P=0.005], fatigue [RR=1.19, 95%CI (0.73, 1.94), P=0.47], febrile neutropenia [RR=1.59, 95%CI (0.89, 2.87), P=0.12], anemia [RR=1.74, 95%CI (0.59, 5.18), P=0.32], and leukopenia [RR=0.77, 95%CI (0.64, 0.93), P=0.005]. ConclusionCapecitabine combined with irinotecan treatment for advanced colorectal cancer is effective and its toxicity is acceptable.

左腹股溝直疝疝囊突入陰囊伴膀胱疝入1例報告

Direct Inguinal Hernia Protrudes into The Scrotum(Report of 12 Cases)

目的探討腹股溝直疝突入陰囊的可能原因及其手術修補方法。 方法回顧性分析筆者所在醫院2005年6月至2013年6月期間收治的353例次腹股溝直疝患者的臨床資料。 結果353例次腹股溝直疝患者，發生疝囊突入陰囊12例次，發生率為3.4%。與未突入陰囊組比較，突入陰囊組患者的年齡大、病程長、疝環口及疝囊大，且多伴有慢性支氣管炎、便秘等導致慢性腹內壓增高的疾患。12例次中采用“疝環充填+平片”修補術1例次，其余11例次均采用腹膜前修補術。術后隨訪6～60個月，平均37個月，無復發病例。 結論腹股溝直疝在少數情況下可以突入陰囊，宜選擇腹膜前間隙疝無張力修補術。