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Objective:To explore the clinical value of urine semi-quantitative colorimetry by sodium dithionite reduction method in the diagnosis and treatment of diquat poisoning.Methods:The data of 49 patients with acute diquat poisoning treated in the First Affiliated Hospital of Nanjing Medical University from December 3, 2020 to November 23, 2022 were retrospectively analyzed, the correlation between urine colorimetric results and plasma diquat concentration was observed, and the predictive value of urine colorimetric results for target organ damage and prognosis were evaluated.Results:There was a significant correlation between urine colorimetric results and plasma diquat concentration, the correlation coefficient was r=0.89, P <0.01. The cut-off value of urine colorimetry for the predicting the damage of gastrointestinal tract, liver, kidney, and central nervous system injury were 2.5, 3.5, 3.5, 5.5, respectively; in which the urine colorimetric results showed the highest sensitivity in predicting digestive tract injury [ AUC 0.93 (95% CI:0.89-1.00)]. The cut-off value of urine colorimetry for the prognosis of death was 4.5, the positive predictive value was 64.2%, and the negative predictive value was 95.2%. Conclusions:The urine semi-quantitative method can be used for rapid prediction of the plasma diquat concentration range on admission. The urine colorimetry results can also effectively predict the occurrence of organ injury and clinical outcome related to diquat poisoning, which provides evidence for the clinical diagnosis and therapy.
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Heart failure is a disease that seriously threatens human health and has become a global public health problem. Diagnostic and prognostic analysis of heart failure based on medical imaging and clinical data can reveal the progression of heart failure and reduce the risk of death of patients, which has important research value. The traditional analysis methods based on statistics and machine learning have some problems, such as insufficient model capability, poor accuracy due to prior dependence, and poor model adaptability. In recent years, with the development of artificial intelligence technology, deep learning has been gradually applied to clinical data analysis in the field of heart failure, showing a new perspective. This paper reviews the main progress, application methods and major achievements of deep learning in heart failure diagnosis, heart failure mortality and heart failure readmission, summarizes the existing problems and presents the prospects of related research to promote the clinical application of deep learning in heart failure clinical research.
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Humanos , Inteligencia Artificial , Aprendizaje Profundo , Insuficiencia Cardíaca/diagnóstico , Aprendizaje Automático , Diagnóstico por ImagenRESUMEN
Objective@#To analyze the relationship between clinical characteristics and prognosis of patients with acute herbicide poisoning marked diquat.@*Methods@#A multi-center, retrospective clinical study of patients with acute diquat poisoning admitted into Emergency Department was conducted from June 2015 to August 2018 in 8 hospitals in Jiangsu Province.@*Results@#A total of 43 patients (22 males and 21 females) were collected and the peak age of poisoning ranged 20-39 years old. The only route of poisoning was ingestion. Among these cases, suicide was the most common cause of poisoningaccounting for 90.70%. In emergency treatment, the constituent ratios of gastric lavage, hemoperfusion and glucocorticoid were 87.50%, 72.50% and 42.50%, respectively. The total mortality increased to 60.00% after follow-up, while the in-hospital mortality was 18.60%. The mortality of patients with toxic dose < 50 mL was 11.11%.@*Conclusions@#The incidence of acute herbicide poisoning with "diquat" as commercial component is gradually increasing. At present, the mortality is very high. Ingestion poisoning dose is the key factor affecting prognosis, and the prognosis of patients with oral dose > 50 mL is poor.
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Objective@#To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization of paraquat (PQ).@*Methods@#Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n = 15) and the saline control group (n = 15). Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization. Mice in the saline control group received an equal volume of saline. Mice were sacrificed 72 h post-PQ administration and samples were collected. The general physical condition of mice including body weight as well as mortality was monitored daily. Pulmonary function, cell counting and classification of bronchoalveolar lavage fluid (BALF), proinflammatory cytokines (TNF-α, IL-1β, and IL-6) levels of BALF and serum, MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained.@*Results@#The body mass of mice decreased progressively within 72 h after PQ intratracheal administration. The static compliance of lung decreased (P<0.01) and the resistance increased (P<0.01). The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P<0.01), the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P<0.01), and the activity of MPO in BALF was also remarkedly increased (P<0.01). The total protein concentration of BALF was significantly elevated (P<0.01). The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage, alveolar collapse, hyaline membrane formation and alveolar septal thickening, and the lung injury scores significantly increased (P<0.01).@*Conclusions@#Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice.
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Objective To investigate the regulatory mechanism of Paraquat (PQ)-induced epithelial-mesenchymal transition (EMT) and the protective mechanism of N-acetyl-cysteine (NAC) in PQ-induced A549 cells by EMT markers (E-cadherin and α-smooth muscle actin).Methods EMT model was established by 30 μmol/L PQ-exposed A549 cells for 4 d.The application of 10 mmol/L NAC was incubated with A549 cells for 2 h in advance.Morphological changes of A549 cells were observed under light microscope.Western blot was used to detect the expression levels of TGF-β1,E-cadherin and α-smooth muscle actin.Results In PQ-induced EMT model,the PQ group showed typical morphological changes,and the cells changed from cobblestone-like epithelial appearance to spindle-shaped mesenchymal-like appearance compared to the control group.Westem blotting showed that the protein levels of TGF-β1 and α-smooth muscle actin in the PQ group were significantly increased and the protein levels of E-cadherin were decreased in the PQ group (all P＜0.05).NAC preincubation can effectively reverse the above changes caused by PQ exposure:the protein levels of E-cadherin and α-smooth muscle actin were significantly increased and decreased,respectively and morphological changes showed more cobblestonelike epithelial appearance.Conclusion Cell experiments showed that PQ exposure can cause EMT in epithelial cells,and NAC has a protective effect in this process.Thus,it may provide new ideas and strategies for the treatment of pulmonary fibrosis caused by PQ poisoning in clinical practice.
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Objective To analyze the relationship between clinical characteristics and prognosis of patients with acute herbicide poisoning marked diquat.Methods A multi-center,retrospective clinical study of patients with acute diquat poisoning admitted into Emergency Department was conducted from June 2015 to August 2018 in 8 hospitals in Jiangsu Province.Results A total of 43 patients (22 males and 21 females) were collected and the peak age of poisoning ranged 20-39 years old.The only route of poisoning was ingestion.Among these cases,suicide was the most common cause ofpoisoningaccounting for 90.70％.In emergency treatment,the constituent ratios of gastric lavage,hemoperfusion and glucocorticoid were 87.50％,72.50％ and 42.50％,respectively.The total mortality increased to 60.00％ after follow-up,while the in-hospital mortality was 18.60％.The mortality of patients with toxic dose ＜ 50 mL was 11.11％.Conclusions The incidence of acute herbicide poisoning with "diquat" as commercial component is gradually increasing.At present,the mortality is very high.Ingestion poisoning dose is the key factor affecting prognosis,and the prognosis of patients with oral dose ＞ 50 mL is poor.
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Objective To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization ofparaquat (PQ).Methods Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n =15) and the saline control group (n =15).Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization.Mice in the saline control group received an equal volume of saline.Mice were sacrificed 72 h post-PQ administration and samples were collected.The general physical condition of mice including body weight as well as mortality was monitored daily.Pulmonary function,cell counting and classification of bronchoalveolar lavage fluid (BALF),proinflammatory cytokines (TNF-α,IL-1β,and IL-6) levels of BALF and serum,MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained.Results The body mass of mice decreased progressively within 72 h after PQ intratracheal administration.The static compliance of lung decreased (P＜0.01) and the resistance increased (P＜0.01).The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P＜0.01),the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P＜0.01),and the activity of MPO in BALF was also remarkedly increased (P＜0.01).The total protein concentration of BALF was significantly elevated (P＜0.01).The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage,alveolar collapse,hyaline membrane formation and alveolar septal thickening,and the lung injury scores significantly increased (P＜0.01).Conclusions Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice.
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Objective To explore the feasibility and convenience of automatic registration ultrasound-CT/MR fusion imaging based on hepatic vessel trees. Methods The PercuNav fusion imaging system of Philips Epiq 7 was used to perform ultrasound-CT/MR fusion imaging on 22 patients with focal liver lesions detected by contrast-enhanced CT or MR.Both automatic registration ultrasound-CT/MR fusion imaging based on hepatic vessel trees and the conventional ultrasound-CT/MR fusion imaging based on internal anatomic landmarks were employed for alignment in these patients.The results including the success rate of registration,duration time of initial registration,error of initial registration,number of times of fine-tuning, duration time of fine-tuning and the overall duration time of registration were compared between these two methods.Results The success rates of registration,duration time of initial registration,errors of initial registration,numbers of times of fine-tuning,duration time of fine-tuning and the overall duration time of registration for automatic registration ultrasound-CT/MR fusion imaging based on hepatic vessel trees and the conventional ultrasound-CT/MR fusion imaging based on internal anatomic landmarks were 72.73% and 95.45%,16.5 s (10~30 s) and 13 s (8~24 s),3 mm (1~14 mm) and 14 mm (2~43 mm),0 time (0 to 2 times) and 1 time (0~3 times),0 s(0~46 s) and 30 s (0~88 s),and 20 s (12~61 s) and 42 s (9~102 s),successively and respectively. There was no statistically significant difference in the success rates between these two methods ( P >0.05).The duration time of initial registration of conventional method was less than that of automatic registration method( P <0.05).The error of initial registration,number of times of fine-tuning,duration time of fine-tuning and the overall duration time of registration of automatic registration method were superior to those of conventional method ( P < 0.05).Conclusions Automatic registration ultrasound-CT/MR fusion imaging based on hepatic vessel trees is feasible. It is also more convenient than conventional ultrasound-CT/MR fusion imaging based on internal anatomic landmarks.
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Objective To discuss the treatment experience of adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The clinical data of 24 cases of AIMAH from August 1972 to December 2016 were retrospectively analyzed.The cases included 10 males and 14 females with a mean age of 43 (range 26 to 59) years.16 patients presented with typical Cushing syndrome (CS) and 8 patients had weight gain, hypertension or diabetes mellitus without any sign of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.The preoperative CT scan showed bilateral enlargement of the adrenal glands with multiple macmnodules.14 patients underwent open surgery, including 5 cases of unilateral adrenalectomy, 6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy simuhaneously.6 patients underwent conventional laparoscopic adrenalectomy,including 2 cases of unilateral adrenalectomy, 2 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 2 cases of bilateral adrenalectomy.4 patients underwent robot-assisted laparoscopic bilateral adrenalectomy.Results The postoperative pathological examination showed that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 68 months (range 3 to 192 months), the clinical symptoms of CS disappeared after surgery in all cases.7 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy simultaneously, 1 case died of adrenal crisis on the seventh day post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in other patients.Conclusions The use of bilateral adrenalectomy to treat AIMAH may involve risk.Unilateral adrenalectomy is recommended for an alternative treatment for AIMAH.Controlateral adrenalectomy with lifelong corticosteroid replacement or contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.
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Objective To evaluate the feasibility,efficacy and tolerability of ultrasound-guided percutaneous radiofrequency ablation(RFA) for treating malignant tumor in the caudate lobe.Methods A retrospective analysis was performed in the patients with malignant tumor in the caudate lobe treated by percutaneous radiofrequency ablation (RFA) from January 2009 to July 2016.The epigastric approach (EA),the intercostal approach (IA) and an approach combining EA and IA were used as the paths of puncture.Intraprocedural contrast enhanced ultrasound (CEUS) was used to evaluate the ablation effect.The enhancement of CT/MR was used as the gold standard to evaluate the ablation effect within 1 to 3 months after surgery.Technical success (TS),technique efficacy (TE),local tumor progression (LTP) and complications were documented.Results A total of 14 patients with 14 malignant tumors in the caudate lobe of the liver were included in this study.The EA,IA,and the approach combining EA and IA were used in 7,6,and 1 patient,respectively.Intraprocedural CEUS showed complete ablation in all cases.CT / MRI evaluation within 1 to 3 months after surgery showed that the complete ablation rate was 100％ (14/14).After a median follow-up of 15.5 months (interquartile range,3 55 months),2 patients had recurrence in other regions of the liver,there was no local tumor progression and no serious complications occurred in 14 patients.Conclusions Ultrasound guided RFA is a safe,effective and important mean for the treatment of malignant tumors in caudate lobe of liver.
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BACKGROUND:The principle of lyophilization is to sublimate the solvent of frozen materials in vacuum and retain the solute, thus making a pore structure. OBJECTIVE: To produce a chitosan tubular scaffold by lyophilization, and to test its physicochemical properties. METHODS: The chitosan tubular material was prepared by lyophilization method, folowed by gross observation and electron microscopic observation. The chitosan tubular material samples were placed into PBS solution and pure water for 50 days, respectively, and then immersed in trypsin liquid for 1 day folowed by embedded into the muscle and dorsal skin of neonatal Sprague-Dawley rats for 30 days. The degradation rate and porosity of the material were observed and calculated. The breaking strength and compressive strength of the material were determined both under drying and soaking conditions using tensile instrument and pressure meter, respectively. RESULTS AND CONCLUSION:The external form of the chitosan tubular material was normaly tubular. Under the electron microscope, it was composited by different size pores, and the pore size was 50-200μm. The degradation rates of the material were (5.33±0.12)% in PBS, (11.26±0.15) in water, 0.012% in the trypsin liquid and (35.2±3.7)in vivo. The porosity rate was (97.5±1.5)%. The breaking strength and compressive strength of the material was higher under the drying state than under the soaking state (P < 0.05). These findings indicate that the lyophilization method can produce the chitosan tubular material with good porosity rate and degradation rate as wel as good tensile ability and compressive capability.
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Objective To review the experience with partial cystectomy combined with chemo-and radiation therapies in the treatment of muscle-invasive bladder cancer (MIBC) to assess the local control and survival rates,and to identify predictive factors for recurrence and survival.Methods From 2002 through 2007,a total of 100 patients with MIBC underwent partial cystectomy combined with adjuvant chemotherapy and radiation therapy (PC group).Meanwhile,36 patients with MIBC underwent radical cystectomy (RC group).The clinical and pathological data of these patients were retrospectively reviewed.Primary endpoints were cancer-specific survival (CSS),bladder-intact cancer-specific survival and bladder cancer recurrence.Results The 5-year CSS rate of the entire cohort was 65％,which was higher in PC group than in RC group (68％ vs 55％,P =0.033).In PC group,only 2 patients (2％) were confirmed to have residual tumor at the time of re-evaluation TUR 3 months after partial cystectomy.After a mean of 33.1 months,46 patients (46％) experienced superficial recurrence and 14 patients (14％) developed muscle-invasive recurrence.75％ of recurrence occurred within 16 months.8 patients underwent salvage cystectomy.The 5-year bladder-intact survival rate was 63％ in PC group.In multivariate analysis,the presence of tumor numbers more than 3 and tumors with infiltrating growth pattern were 2 predictive factors for cancer recurrence in PC group.In terms of survival,the presence of tumor numbers more than 3,lymphovascular invasion and partial cystectomy plus ureteral reimplantation (PC plus UR) were significantly associated with 5-y CSS in PC group and PC plus UR was indeed a protective factor for survival.By looking at the entire MIBC cohort,lymphovascular invasion,tumor numbers more than 3,history of superficial bladder cancer and age greater than 70 years old were identified as independent predictive factors for 5-y CSS.Conclusions Combined with adjuvant chemo-and radiation therapies,partial cystectomy might be a alternative to radical cystectomy for the treatment of MIBC,which provides adequate local control in selected patients,as well as acceptable survival rate.
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Objective To improve the diagnosis and treatment ot adrenocorticotropin-independent macornodular adrenal hyperplasia (AIMAH).Methods The clinical data of 17 cases with AIMAH from 2000 to 2011 were analyzed retrospectively,including 3 subclinical AIMAH,10 clinical AIMAH and 4 highrisk AIMAH patient,with common radiological characteristic of bilaterally enlarged adrenal glands with multiple nodules like ginger.The 3 cases of subclinical AIMAH patients presented with decreased serum ACTH,normal or slightly elevated plasma cortisol and urinary free cortisol level,no suppression following 1 mg overnight dexamethasone suppression test and absence of clinical signs of Cushing syndrome (CS).While clinical AIMAH and high-risk AIMAH presented with clinical signs of CS,elevated plasma cortisol and urinary free cortisol level,suppressed serum ACTH,loss of normal circadian rhythm in cortisol secretion and no suppression following the low-dose and high-dose overnight dexamethasone suppression test.Among the 4 cases of high-risk AIMAH,2 cases presented with osteoporosis,2 cases with hepatic dysfunction,3 cases with cardiopulmonary dysfunction,and 4 cases with severe hypertension.Three cases of subclinical AIMAH were treated with symptomatic treatment,10 cases of clinical AIMAH patients with surgical operation,4 cases of high-risk AIMAH patients with ketoconazole and surgical operation.Results Three subclinical AIMAH patients received symptomatic treatment and discharged from hospital with normal blood pressure and blood glucose.During the period of follow-up from 3 months to 3 years,endocrine results were normal.Seven clinical AIM AH patients underwent unilateral adrenal tumor resection plus ipsilateral partial adrenalectomy or total adrenalectomy.CS disappeared completely after 6 to 9 months.Two clinical AIMAH patients underwent simultaneous bilateral adrenalectomy.One case died of adrenal crisis after operation,and the other case presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy,no Nelson's syndrome happened during the follow-up for 5 years.One clinical AIMAH patient undertook unilateral adrenalectomy twice by interval,followed by routine corticosteroid replacement therapy.Followed up for 10 years,no Nelson's syndrome happened.Four high-risk AIMAH patients received ketoconazole and then underwent right total adrenalectomy.Cortisol levels returned to normal after 1 to 2 months and during the follow-up for 1 to 3 years,the laboratory examinations maintained normal.Conclusions Different treatment methods should be adapted to different subtypes of AIMAH.For subclinical AIMAH,the principal treatment is symptomatic,and close follow-up with regular adrenal imaging and endocrine examination is required.Surgical operation should be performed when clinical symptoms of AIMAH appear.Medical management is essential for high-risk AIMAH to inhibit the production of cortisol at first.Once these patients could stand the stimulation caused by operation,the adrenal glands should be resected as soon as possible.The unilateral adrenalectomy is an effective treatment for clinical AIMAH.
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Objective To investigate the diagnosis and treatment of extra-adrenal pheochromocytoma(EAP). Methods The clinicsl data of 37 cases of EAP from April 2003 to April 2010 were retrospectively analyzed.Hypertension was observed in 31 cases.The typical triad of headache,palpitation and sweating was observed in 12 cases.The positive rate of plasma-free MNs and 24-hour urinary CA in diagnosing EAP was 96.8%(30/31) and 86.5% (32/37) respectively.The main localization diagnosis included ultrasonography,CT,MRI and 131I-MIBG,with positive rates of 91.7% (33/36),97.0%(32/33),90%(9/10) and 82.6%(19/23) respectively.Two patients underwent radiotherapy, and the remaining 35 cases underwent surgical treatment. Results Among the total of 37 cases,32 cases were single tumor,and five were multiple tumors.The anatomic locations of the single tumors were as follows: 14 wre adjacent to the abdominal aorta,seven in the bladder,four adjacent to the inferior vena cava,four adjacent to the renal hilum,two adjacent to the lilac blood vessel and one in the upper pole of the right kidney.Thirty cases underwent complete tumor resection,three cases underwent tumor resection plus right nephrectomy and two cases underwent partial cystectomy.Twenty-four cases were diagnosed benign and 11 cases were diagnosed malignant by pathological examination.Among 31 cases with preoperative hypertension,postoperative blood pressure returned to normal in 23 patients,blood pressure descended mildly in six cases and blood pressure was still hypertensive in two cases.Thirty-four patients were followed up for five months to seven years,during which five cases had tumor recurrence or metastases and five cases died postoperatively. Conclusions EAP is a rare neuroendocrine tumor and its accurate diagnosis is rather difficult.Plasma-free MNs and 24-hour urinary CA are important qualitative examinations.Ultrasonography,CT,MRI and 131I-MIBG scintigraphy are important methods for the localization of the tumor.Transperitoneal resection of the tumor is the preferred choice of management and adequate perioperative preparation is the key to a successful operation,including bringing down blood pressure,expanding blood volume and correcting arrhythmia.Patients with malignant EAP may be treated with 131I-MIBG after surgical therapy.
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be diagnosed by imaging examination before operation.The ALT patients with large or symptomatic adrenal lipomatous lesions or preoperatively diagnosed teratoma should be given surgical treatment.
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Objective To evaluate the comprehensive treatment results of cystitis glandularis. Methods A total of 65 cases of cystitis glandularis underwent cystoscopy.The results showed follicular or villous changes in 39 cases,papillomatous in 15,chronic inflammation in 8 and no obvious change in 3.Transurethral electric resection or partial cystectomy were performed.After surgery all the cases received mitomycin-c bladder irrigation at high dose (40 mg once) regularly for 2 years.During the follow-up cystoscopy was periodically performed and the biopsy samples were pathologically examined with all the cases. Results The mean follow-up was 29 months (range,7 to 72 months).Of the 65 cases,60 fully recovered with transitional cell surface covering the bladder musoca gradually;4 had relapse;and 1 developed canceration (adenocarcinoma). Conclusions Transurethral resection of bladder tumors or galvanocautery is the essential therapy for cystitis glandularis.After surgery the bladder irrigation with mitomycin-c at high dose can be helpful for urothelium recover in histology.
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Objective To detect plasma renin activity(PRA) and kidney damage in primary hyperaldosteronism(PA). Methods The duration of hypertension,serum creatinine and aldosterone levels,recumbent and upright PRA levels were detected and studied in 76 PA patients.Correlation was measured between creatinine and other parameters. Results Serum creatinine level correlates closely with upright PRA ( P
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Objective To evaluate the value of 3-dimensional dynamic contrast-enhanced magnetic resonance angiography (3D DCE MRA) in the diagnosis of adrenal and renal diseases.Methods 3D DCE MRA was performed on 22 patients with adrenal neoplasm,23 patients with renal neoplasm and 2 patients with stenosis of renal artery. Comparison with surgical findings or DSA was made.Results 3D DCE MRA clearly reflected the vascular anatomy,satisfied diagnostic demands.Simultaneously,The extravascular lesions were also detected.Conclusion The 3D DCE MRA is a reliable non-damaged imaging diagnostic method.
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The clinical data of 39 cases of idiopathic hyperaldosteronism (IHA) confirmed by operation were analyzed. The indications of operation consisted of (1) unable controlled the patients′ conditions by pharmacotherapy, (2) severe side effects due to high doses of medication and (3) difficulty in distinguishing between adenoma and nodule hyperplasia. The unilateral total adrenalectomy was suggested.
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Objective To study the diagnosis and treatment of adrenal tumors. Methods 1 006 cases of adrenal tumors treated from 1957 to 2000 were reviewed. Results Of the 1 006 cases of adrenal tumors,845(84.0%) were functional with 12(1.4%) malignant and 161(16%) nonfunctional with 11( 6.8%) malignant.There were 180 incidentaloma including 19 pheochromocytoma.A total of 996 tumors have been surgically removed and 10 cases underwent surgical exploration only.The total mortality rate was 0.3%. Conclusions Adrenal tumors occurred mostly in patients of 30～50 years of age.The prevalence of Cushing syndrome was more in females than in males.Ultrasonography and CT are the method of choice for the localization of the tumor whereas hormone levels should be determined both in the symtomatic and asymtomatic patients with adrenal tumors.Functional adrenal tumors and solid incidentaloma of large size should be surgically removed while asymtomatic incidentaloma less than 3 cm in size could be observed and followed up and surgery might be undertaken when indicated.