颈部甲状腺横纹肌肉瘤二例

横纹肌肉瘤为原发于横纹肌组织中的恶性肿瘤,恶性程度与病死率均较高.本文报告2例发生在甲状腺的横纹肌肉瘤.     

宫颈胚胎性横纹肌肉瘤1例临床分析

横纹肌肉瘤是好发于青少年的软组织恶性肿瘤,可发生于机体各个部位,最常见发生于头颈部,其次发生于生殖道。而发生于女性生殖道的横纹肌肉瘤则以发生于阴道部病变为多,原发于宫颈的横纹肌肉瘤占横纹     

成年女性生殖系统原发性横纹肌肉瘤的临床病理学特征（英）

横纹肌肉瘤（RMS）是小儿最常见的软组织肿瘤。在儿童，〉20％的横纹肌肉瘤原发于生殖道，为该肿瘤第二常见部位，而成人生殖系统原发PMS不常见。本课题主要研究成年女性生殖系统原发PMS的临床与病理学特征。复习≥16岁RMS患者的组织切片，将符合WHO（2002）女性生殖系统肿瘤分类中所描述的具有经典组织学特征的病例纳入本研究，     

头颈部横纹肌肉瘤(附68例分析)

对６８例头颈部横纹肌肉瘤临床资料进行小结，发现８０％发现于１０岁之前，原发部位于耳鼻咽喉者相对少见；其病理类型以胚胎型占绝大多数（７４％）；三年成活率，原发于眼及眼眶者最好，达６７％，原发于耳鼻咽喉者最差，仅１９％。     

头颈部横纹肌肉瘤

对６８例头颈部横纹肌肉瘤临床资料进行小结，发现８０％发现于１０岁之前，原发部位于耳鼻咽喉者相对少见，其病理类型以胚胎型占绝大多数（７４％），三年成活率，原发于眼及眼眶者最好，达６７％，原发于耳鼻咽喉者最差，仅１９％。     

胃原发胚胎性横纹肌肉瘤临床诊断学特征及文献复习

目的探讨胃原发性胚胎性横纹肌肉瘤的临床诊断学特征。 方法回顾性分析1例临床表现为成人原发于胃的胚胎性横纹肌肉瘤患者的临床资料,并进行相关文献复习。 结果患者表现为腹痛、腹部肿物等,胃镜显示胃贲门、胃底、胃体占位,贫血胃,胃窦息肉。胃镜病理结果提示胚胎性横纹肌肉瘤,镜下肿瘤细胞弥漫分布,排列呈片状、巢状,瘤细胞较小,呈圆形,核深染,居中或偏位,胞质少,核分裂易见。免疫组化Myogenin＋,Desmin＋。 结论成人原发于胃的胚胎性横纹肌肉瘤是一罕见的高度恶性软组织肿瘤,需要结合临床影像学、病理学、免疫学等多种诊断方法,可作出正确诊断。     

中耳胚胎性横纹肌肉瘤CT误诊1例

横纹肌肉瘤是软组织中较常见的恶性肿瘤，它包括胚胎性横纹肌肉瘤、腺泡型横纹肌肉瘤、葡萄状横纹肌肉瘤和多形性横纹肌肉瘤4种类型。其中胚胎性横纹肌肉瘤常见于小儿，恶性程度比多形性横纹肌肉瘤高，预后极差，极易复发。它多生长在头颈部的眼眶周围，外耳道、鼻腔、齿龈、舌和上颌窦等处。儿童也可见于泌尿生殖器官如阴道、膀胱、前列腺以及精囊等。     

儿童盆腔及泌尿生殖系统横纹肌肉瘤的超声诊断

目的 探讨超声检查在儿童盆腔及泌尿生殖系统横纹肌肉瘤的诊断价值.方法 对23例经病理证实的原发盆腔及泌尿生殖系统横纹肌肉瘤的超声检查结果进行分析.结果 23例横纹肌肉瘤中,膀胱横纹肌肉瘤10例;阴道横纹肌肉瘤1例,伴腹盆腔及腹股沟淋巴结转移;前列腺横纹肌肉瘤2例;盆腔横纹肌肉瘤10例,其中腹股沟淋巴结转移1例,盆腔淋巴结转移1例.本组盆腔及泌尿生殖系统横纹肌肉瘤超声多表现为肿瘤边缘清楚,无包膜回声,形态规则或不规则形,内部为较均质的低回声,部分肿瘤内部可见液化坏死.结论 超声检查可了解横纹肌肉瘤来源、部位,测量肿块大小及与周围组织关系,有无腹盆腔内淋巴结转移等,便于随访,可作为盆腔及泌尿生殖系统横纹肌肉瘤影像学检查的首选方法.     

PICC在软组织肉瘤化疗中的应用及护理

软组织肉瘤是原发于纤维组织、神经纤维、滑膜、脂肪、血管、平滑肌及横纹肌等的恶性肿瘤，其治疗主要以手术切除、放射治疗、动脉内化疗、全身化疗及综合治疗为主。在软组织肉瘤的化疗中，本科主要采用ADI(ADM、DTIC、IFO)方案静脉滴注持续96h化疗。但由于ADM、DTIC均属发疱性药物，外周静脉持续滴注对静脉损伤大，静脉炎发生率较高，一     

左心房及二尖瓣多发肉瘤1例

<正>原发心脏恶性肿瘤是一种原发于心腔及其相通大血管的肿瘤,因罕见而易误诊。发病率很低,多见于个案报道,有报道称原发心脏肿瘤的发病率为0.001%-0.03%,其中恶性占25%[1-3]。常见原发心脏恶性肿瘤类型为血管肉瘤、横纹肌肉瘤,其次是淋巴瘤。可出现于心脏任何部位,以右心系统多见,多见于右房、其次为大血管[2,3]。该病临床症状出现较晚且无特异性,早期诊断困难,生存期较短,预后很差,因     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

Clinical Trial Updates and Hotline Sessions presented at the European Society of Cardiology Congress 2007

This article provides information and commentaries on trials which were presented at the Hotline and Clinical Trial Update Sessions at the European Society of Cardiology Congress 2007 in Vienna. The key presentations were performed by leading experts in the field with relevant positions in the trials or registries. It is important to note that unpublished reports should be considered as preliminary data, as the analysis may change in the final publications. The comprehensive summaries have been generated from the oral presentation and the webcasts of the European Society of Cardiology and should provide the readers with the most comprehensive information of relevant publications.     

Balance and Boundaries in Grief Counseling: An Intervention Framework for Volunteer Training

Volunteers or paraprofessional counselors are commonly used to provide supportive care to the bereaved. These counselors generally are trained in basic listening skills, providing a generic, nonspecific approach to intervention that remains to be proven effective. The present paper outlines a framework that provides paraprofessionals with a broader model for intervention with the bereaved. Attention to boundaries as a helper and balance in the grief recovery are central to the model. Interventions are described that provide the paraprofessional counselor with more options for tailoring their counseling strategy to the individual. These include techniques that are presumed to be more specific to the enhancement of grief recovery.     

A new method for the simultaneous analysis of unmodified and modified urinary nucleosides and nucleobases by high performance liquid chromatography

Details are given of a new, rapid and simple pre-fractionation method and an isocratic high performance liquid chromatography system suitable for parallel analysis of nucleosides and nucleobases from urine and other biological fluids. The quantitative recovery and excellent reproducibility of the method is demonstrated by analysis of representative standard RNA catabolites. The advantage of this new method for application to biological samples is discussed.     

Adsorption of Charged Non-albumin Bound Drugs by Amorphous Silica

We investigated the in vitro drug adsorption of PQ 10150 sodium silicate gel (AIS, Santa Clara, CA) with particle size of 230 um and surface area of 400 nr/g. We observed 99% to 88% adsorption of gentamicin; a mean 91 % of disopyramide; a mean 89% of quinidine at low concentration, falling to 75% at higher concentration. Insulin was 88% adsorbed at low concentrations but less so (65%) at higher concentrations. We observed a mean 83 % adsorption of procainamide, a mean 84% of N-acetyl procainamide, 74% oflidocaine, 73% of amitriptyline; and 44% of desipramine. We found an average 14% reduction of total digoxin concentration when serum containing digoxin (2 to 33 ng/mL) was exposed to sodium silicate, while the reduction in free digoxin concentration was 16%. Five percent ethosuximide was also removed. The adsorption of theophylline, phenobarbital, acetaminophen, phenytoin, ethylene glycol, methotrexate, salicylate, thiocyanate and diazepam was minimal and not significant. We conclude that significant amounts of charged, non-albumin bound drugs can be removed by PQ 10150 sodium silicate gel.     

自动化酸碱平衡图在急诊社区获得性肺炎诊治中的应用

目的 探讨自动化酸碱平衡图在急诊科社区获得性肺炎(CAP)患者诊断中的价值.方法 根据病史、肺功能测定结果、慢性阻塞性肺疾病(COPD)诊断标准,将111例CAP患者分为单纯CAP组(56例)和COPD合并CAP组[即慢性阻塞性肺疾病急性加重(AECOPD)组,55例].询问患者病史后即刻抽取动脉血测血气并进行自动化酸碱平衡图分析.结果 血气分析结果显示,AECOPD组动脉血二氧化碳分压(PaCO2,kPa)、HCO3- (mmol/L)、剩余碱(BE,mmol/L)均显著高于CAP组(PaCO2:7.714±2.414比5.896±1.308,HCO3-:30.767±7.185比25.014±3.043,BE:4.345±5.371比-0.354±3.180,均P＜0.01).自动化酸碱平衡图分析结果显示,AECOPD组患者酸碱平衡紊乱高达89.1％,CAP组为66.1％.将AECOPD组和CAP组患者中正常(10.9％、33.9％)、急性呼吸性酸中毒(急性呼酸,12.7％、14.3％)、慢性呼吸性酸中毒(慢性呼酸,49.1％、10.7％)、呼吸性碱中毒(呼碱,7.3％、14.3％)、代谢性酸中毒(代酸,12.7％、17.9％)、代谢性碱中毒(代碱,12.7％、8.9％)综合进行x2分析,差异有统计学意义(x2=24.421,P=0.001),而将正常、急性呼酸、呼碱、代酸及代碱进行x2分析,差异无统计学意义(x2=5.280,P=0.260),提示AECOPD患者慢性呼酸的发生率较单纯CAP患者显著增加.结论 自动化酸碱平衡图能帮助急诊科医师快速识别CAP患者是否存在多重酸碱平衡紊乱,并可快速识别急、慢性呼吸系统疾病.