The general classification of prostate cancer pathology

1. Latent prostate cancer: is not in his prostate disease symptoms and signs, in the autopsy after death by pathological examination revealed the primary adenocarcinoma of the prostate. Potential prostate cancer can occur in any location, but to the central area and peripheral areas common, and often well-differentiated adenocarcinoma. Its incidence of foreign reported a 15% to 50%. My urinary Research Institute reported latent prostate cancer incidence rate was 34%. Statistical studies show that the incidence of prostate cancer may be hidden with the environment and genetic factors.
2. Sporadic prostate cancer: Clinical to benign prostatic hyperplasia as the main symptoms, in the resection of prostate hyperplasia, histological examination revealed prostate cancer. Its histological differentiation better performance for adenocarcinoma, and to sieve-like tubular adenocarcinoma adenocarcinoma based, a small number of poorly differentiated adenocarcinoma, sporadic abroad prostate cancer incidence rate of 10% to 30%. Domestic morbidity reports to about 5%.
3. Misprision of prostate cancer: patients without symptoms and signs of prostate disease, but in lymph node biopsy or specimens for pathological examination confirmed prostate cancer. And then after prostate biopsy has been further confirmed. Such serum prostate specific antigen (PSA) and prostatic acid phosphatase levels increased. PSA and biopsy done (or) PAP immunohistochemistry staining were positive.
4. Clinical prostate cancer: clinical examination (referring to consultation, ultrasound, CT or MRI, etc.) for the diagnosis of prostate cancer, and a biopsy confirmed. Also available through PAP patients with increased serum PSA and to assist diagnosis. Most patients can touch DRE prostate nodules, ultrasonography suggested that prostate nodule is not structured shape, Echo Echo low and uneven.

Treatment of elderly people infected with liver cirrhosis

Concurrent with the treatment and attention to matters: Cirrhosis of older persons is the most common infections in spontaneous peritonitis, lung infections, gastro-intestinal infections, urinary tract infection. The most common pathogenic bacteria are gram-negative bacteria, and because of large-scale use of broad-spectrum antibiotics and immune dysfunction, anaerobic bacteria and fungal infections is increasing. Therefore, in elderly patients with cirrhosis infection should pay attention to the following questions: 1. Spontaneous peritonitis in elderly patients with liver cirrhosis in particular, ascites due to cirrhosis patients, abdominal infection is a common infection sites, so when patients with abdominal pain and the reasons could explain the elevated blood leukocytes, and the corresponding ascites in PMN (PMN )> 0.25 * 109 / L, should consider the possibility of spontaneous peritonitis. Should be selected in the ascites in a timely manner to reach adequate concentrations of broad-spectrum anti-Su. Penicillin and uncomfortable choice Tanzanian agents. If sultamicillin, or second, and third-generation cephalosporins, intravenous drug 10 to 14 for a course of treatment. 48 hours after repeated treatment of abdominal wear, check ascites, to estimate the effect of antibiotics. If the treatment effective, multi-shaped cells decreased more than 50 percent, bacterial culture negative, it is not necessary to replace antibiotics. For four days as invalid, or culture of drug use is not sensitive, required under the susceptibility testing or replacement of antibiotics. 2. More young people choose the right antibiotic repeated application of a variety of antibiotics, the elderly now have no application to the special anti-bacterial drug therapy is usually applied bactericidal drugs. Under the guidance of micro-organisms in the choice of drugs, more applications β-lactone Amine antibiotics, to avoid the application of security on the antibiotics. Oral antibiotics elderly and the absorption of young people without much different, the use of intramuscular injection of muscle tissue due to the elderly decreased, activity was relatively small and more young and middle-aged man-made low. Antibiotics into the blood, because the elderly to reduce serum albumin, the free serum concentration than the young people high. Principal places of antibiotics metabolism and excretion way to liver and kidney. The elderly should do everything possible to avoid the use of sugar-type drugs. To be used at small doses, to a short course of treatment, close observation of renal function. 3. To maintain the normal intestinal flora, Erchongganran prevent the permanent normal bacteria in the digestive tract at least 120 species. Bifidobacterium which is host to many important physiological functions, the reduction or disappearance of bacteria-causing bacteria and intestinal flora imbalance of intrusive. The elderly in the intestinal flora Bifidobacterium decreased significantly, and of Clostridium perfringens, Bacteroides and Enterobacter more. In the use of broad-spectrum antibiotics easily aroused dysbacteriosis, Erchongganran. Therefore, in large doses, prolonged use broad-spectrum antibiotics: 1) to pay attention to eating too much consumption of pork to make bogey, with more saturated fatty acids because the animal fat to the food structure of Bacillus and Clostridium reproduction role. Carbohydrates with crude for good. Cellulose with more food and vitamin B, can foster and promote anaerobic bacteria such as enterococci defecation. 2) the protection of anaerobic bacteria in the use of antibiotics for various infections, in addition to the eradication of blood or tissue anaerobic bacteria, the bacteria in the gut bacteria of oxygen must be protected, is the presence of anaerobic bacteria to resist colonization An important factor. 3) the rational use of antibiotics to avoid the use of antibiotics permanent injury.

Ascites treatment of cirrhosis of the elderly

Ascites due to cirrhosis of the elderly NOTES: l, rational use of diuretics, the elderly ascites due to cirrhosis of the use of diuretics should be in accordance with the joint, intermittent, alternating application of the principle of strict control indications. Reply hour as far as possible in 1000 ml or more. Can not diuretics. Drugs should be chosen LIU Xiao-dose diuretic, intermittent treatment, Pai K-K and joint use of diuretics. Some people do not advocate the use of the elderly thiazin-type diuretics, can cause renal vasoconstriction, reduce kidney blood flow. After the application of diuretics. Should be slow to reduce weight. The elderly to be noted in the use of diuretics can cause acute hearing loss, hypokalemia, liver coma, functional kidney failure, it should be carefully observed condition. That deal with problems in a timely fashion, and medication adjustments. 2, catharsis and abdominal puncture release of elderly patients with cirrhosis due to the whole situation is worse than the young, the elderly and the catharsis abdominal puncture a large number of non-tolerance. Should be anti. In the hypokalemic with, hyponatremia ascites due to cirrhosis patients oral 20% mannitol, because drainage from the intestine and electrolyte loss reduced, while lowering portal pressure. For the merger to eliminate gastrointestinal bleeding in patients with intestinal bleeding, can reduce the occurrence of liver coma. However, attention should be paid to a number of people to make too many. Laparoscopies should be put in a small amount of liquid, a number of principles to prevent a large number of liver-induced coma ascites. 3, less weight ascites and diuretics to lose this method is more suitable for elderly patients, the principle is ascites Zaishu people in the same unit of time should not exceed the amount of urine 500 ml.

Ascites treatment of cirrhosis of the elderly

Ascites due to cirrhosis of the elderly NOTES: l, rational use of diuretics, the elderly ascites due to cirrhosis of the use of diuretics should be in accordance with the joint, intermittent, alternating application of the principle of strict control indications. Reply hour as far as possible in 1000 ml or more. Can not diuretics. Drugs should be chosen LIU Xiao-dose diuretic, intermittent treatment, Pai K-K and joint use of diuretics. Some people do not advocate the use of the elderly thiazin-type diuretics, can cause renal vasoconstriction, reduce kidney blood flow. After the application of diuretics. Should be slow to reduce weight. The elderly to be noted in the use of diuretics can cause acute hearing loss, hypokalemia, liver coma, functional kidney failure, it should be carefully observed condition. That deal with problems in a timely fashion, and medication adjustments. 2, catharsis and abdominal puncture release of elderly patients with cirrhosis due to the whole situation is worse than the young, the elderly and the catharsis abdominal puncture a large number of non-tolerance. Should be anti. In the hypokalemic with, hyponatremia ascites due to cirrhosis patients oral 20% mannitol, because drainage from the intestine and electrolyte loss reduced, while lowering portal pressure. For the merger to eliminate gastrointestinal bleeding in patients with intestinal bleeding, can reduce the occurrence of liver coma. However, attention should be paid to a number of people to make too many. Laparoscopies should be put in a small amount of liquid, a number of principles to prevent a large number of liver-induced coma ascites. 3, less weight ascites and diuretics to lose this method is more suitable for elderly patients, the principle is ascites Zaishu people in the same unit of time should not exceed the amount of urine 500 ml.

Renovascular hypertension pathology

Renovascular hypertension is due to ischemia caused renin - angiotensin - aldosterone axis and the activation. Suffering from renal perfusion due to a decrease in the release of renin, the renin-angiotensin reasons prompted into angiotensin Ⅰ, angiotensin Ⅰ as angiotensin-converting-enzyme conversion of angiotensin Ⅱ. Angiotensin Ⅱ is a strong contraction of blood vessels, angiotensin Ⅱ (A Ⅱ) can stimulate the adrenal gland secretion of aldosterone, a sodium retention. Obstructive renal artery disease can be unilateral or bilateral disease, or occurred in patients with kidney alone, the different types of vascular renal pathophysiology of hypertension is not the same. In renal mode (renal, a clamp-type kidney), ischemic renal Shuinazhuliu lead to the release of renin, but the opposite appears normal kidney diuretic row of pressure sodium, so that patients actually a negative balance of sodium, Further increased the renin release. Kidney in a single mode (single kidney, kidney clamp-type), not the impact of contralateral kidney, thus preventing the loss of sodium, extracellular fluid volume increase in blood renin inhibition activity, increased blood pressure in patients with such major Is caused by excess body fluids. In patients with renal artery stenosis with a similar situation.