Objective To discuss the diagnosis and treatment of normotensive pheochromocyto-ma. Methods The clinical data of 22 patients with normotensive pheochromocytoma were reviewed. Inclusion criteria for normotensive pheochromocytoma were no previous history of hypertension and episode of symptoms suggesting high blood pressure. The blood pressure on admission was 90-130/ 60-90 mm Hg with an average of 113/72 mm Hg. Seven patients were found adrenal mass by routine ultrasonic examination. Twelve patients presented with superior abdominal or flank pain. Four pa-tients were present with fatigue, and 2 patients had fever. Headache and palpitation were found in 1 patient. Most of patients were present with large and round mass with low density area in the center of the tumor by uhrosonography and CT. Four patients had elevated level of plasma epinephrine and nor-epinephrine. 24 hours urine CA and VMA were elevated in 5 and 4 patients respectively. Seven pa-tients were prepared with infusion preoperatively to expand intravascular volume, and 2 patients were given prazosin 1.5 mg/d for 5 to 7 days. Results During the operation, seventeen patients had ele-vated blood pressure and 5 patients had no changed. One of seven patients with preoperative prepara-tion had obvious hypertension during operation, and 11 of 15 patients without preoperative preparation had obvious hypertension. The tumors were removed successfully in 21 patients. All the patients were diagnosed pheochromocytoma pathologically. Twenty-one patients had normal blood pressure with no recurrence during the follow-up from 1 month to 7 years. Conclusions The patients with normotensive pheochromocytomas may have lower catecholamine in their plasma and urine. The application of α-blockers and the expanding intravascular volume before operation could be important for the patients safe.
Key words:
Adrenal gland neoplasmas; Pheochromocytoma; Normal blood pressure; Perioperative care
To investigate the value of sildenafil in the treatment of prostatitis-related sexual dysfunction.Two hundred and eighty patients with chronic prostatitis complicated by sexual dysfunction were radomized into two groups, on treated with sildenafil, and the other with Quinolone. Results were analyzed by comparing the chronic prostatitis symptoms (CPSI score), sexual dysfunction symptoms (PSFI score) and anxiety symptoms (SAS score) between pre-treatment and post-treatment groups.The degree of prostatitis-related sexual dysfunction was not correlated with that of prostatitis symptoms. The prostatitis symptoms and sexual function were improved after sildenafil treatment compared with the control (P < 0.05), and anxiety score after treatment was significantly lower than the control (P < 0.05).Sildenafil not only works on prostatitis-related sexual dysfunction but also improves the symptoms of prostatitis and anxiety.
Early determination of prognosis in patients with acute-on-chronic liver failure (ACLF) is crucial for optimizing treatment options and liver allocation. This study aimed to identify risk factors associated with ACLF and to develop new prognostic models that accurately predict patient outcomes.
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