Malignant Peripheral Nerve Sheath Tumor: An Unusual Cause of Intussusception

Malignant peripheral nerve sheath tumors (MPNST) are defined as any tumor arising from a peripheral nerve or showing nerve sheath differentiation. The majority of these tumors arise on the trunk, extremities, or head and neck region. The literature to date has fewer than 14 cases of MPNST arising in the gastrointestinal tract, and only two cases were ever reported in the small intestine, one of which was a recurrent disease. In this paper, we report the first US case of an MPNST arising in the small intestine and presenting as intussusception.     

夹板固定与石膏固定治疗桡骨远端关节外骨折的疗效比较

我院自2002年1月-2005年5月,对126例桡骨远端关节外骨折分别采用石膏固定和小夹板外固定,并对这两组治疗方法和疗效进行回顾性分析。1资料与方法1.1临床资料本组126例,男42例,女84例;年龄23～82岁,平均54.4岁。致伤原因:车祸伤15例,滑倒或高处坠落伤96例,其他伤15例。左侧46例,     

Broad ligament hernia-associated bowel obstruction.

BACKGROUND AND OBJECTIVE: We present the case of a female patient 29 years of age with antecedents of laparoscopic laser ablation for endometriosis, laparoscopic appendectomy, and umbilical hernioplasty. METHODS: The patient was admitted to the hospital's emergency room for abdominal pain in the epigastrium, transfixing, irradiating to both upper quadrants and to the lumbar region, accompanied by nausea and gastrobiliary vomiting. Lipase determination was 170 mg/dL. Other laboratory findings were normal. Plain abdominal films on the patient's admission were normal, and computed tomography (CT) showed data compatible with acute pancreatitis. Without improvement during the patient's hospital stay, pain and vomiting increased in intensity and frequency. RESULTS: New abdominal x-rays revealed dilatation of small bowel loops. Management was begun for intestinal obstruction, with intravenous hydration and placement of a nasogastric tube without a good response. At 48 hours, a diagnostic laparoscopy was performed, revealing a 3-cm internal hernia in the left broad ligament in which a 20-cm segment of terminal ileum was encased. We performed liberation of the ileal segment and closed the hernial orifice by using the laparoscopic approach. CONCLUSION: The patient's evolution was excellent.     

小肠原发性非霍奇金淋巴瘤34例临床分析

目的探讨小肠淋巴瘤的临床特点、治疗和预后。方法对1996年1月至2005年12月间收治的经组织病理学明确诊断、并作免疫学分型的原发性小肠淋巴瘤34例患者的临床资料进行分析。结果27例为B细胞淋巴瘤，7例为T细胞淋巴瘤。腹痛和肠梗阻是主要临床表现。用Ann Arbor分期，22例为Ⅰ～Ⅱ期，其中B细胞淋巴瘤20例（74．1％），T细胞淋巴瘤2例（2／7）；12例为Ⅲ～Ⅳ期，其中B细胞淋巴瘤7例（25．9％），T细胞淋巴瘤5例（5／7）；小肠B细胞淋巴瘤的分期低于T细胞淋巴瘤（P〈0．05）；27例行手术治疗，14例行6次化疗[方案为CHOP（环磷酰胺、阿霉素、长春新碱和强的松龙）]，8例同时加用抗CD20单克隆抗体Rituximab。T细胞淋巴瘤急诊手术率高于B细胞淋巴瘤（P〈0．05），B细胞淋巴瘤更易达到完全缓解（P〈0．05），累计生存率高于T细胞淋巴瘤（P〈0．05）。结论小肠B细胞淋巴瘤Ⅰ和Ⅱ期对手术和化疗效果佳，T细胞淋巴瘤的治疗效果和预后不满意。     

标准外伤大骨瓣开颅术在重型颅脑损伤中的应用

目的 探讨及评价标准大骨瓣开颅术在交通事故性重型颅脑损伤中的应用价值.方法 采用标准大骨瓣开颅术治疗交通事故后46例重型颅脑损伤患者,对其相关的临床资料进行分析总结,3个月后采用GOS评定治疗效果.结果 随访3个月后,患者恢复良好23例,中残5例,重残或植物生存8例,死亡10例.结论 标准外伤大骨瓣手术是治疗交通事故性重型颅脑损伤的有效方法,它具有操作方便、彻底减压的优点,能明显提高治愈率,减轻后遗症,提高患者生存质量.     

评价酶联免疫检测血清CYFRA21—1对非小细胞肺癌的诊断价值

目的评价检测ＣＹＦＲＡ２１┐１对非小细胞肺癌的诊断价值。方法用ＥＬＩＳＡ法测定７０例肺癌（ＬＣ）其中４７例非小细胞肺癌（ＮＳＣＬＣ），３例小细胞肺癌（ＳＣＬＣ）和２０例未分型肺癌、６４例肺部良性疾病患者及４０例健康人血清ＣＹＦＲＡ２１┐１浓度。试验的诊断性能用相对操作特征（ＲＯＣ）分析法估测之。结果测得全阈诊断准确率（ＯｖｅｒａｌＤｉａｇ┐ｎｏｓｔｉｃＡｃｃｕｒａｃｉｅｓ）ＬＣ为０．７５、ＮＳＣＬＣ为０．７６，ＳＱＣ为０．８３，ＡＤＥ为０．６７和ＳＣＬＣ为０．３８。在相应于特异性为０．９５的界定值３．４７μｇ／Ｌ处，各型的灵敏度分别为ＳＱＣ０．６２，ＬＣ０．５３，ＮＳＣＬＣ０．５１，ＡＤＥ０．４８和ＳＣＬＣ０．００。结论结果显示ＣＹＦＲＡ２１┐１是ＮＳＣＬＣ较灵敏和特异的一个标志物。未观察到ＴＮＭ各期间该标志物的平均水平有明显的差异；然而异常升高水平的患者的比例随病期的进展而显著增加，提示一系列检测ＣＹＦＲＡ２１┐１水平可能有助于监查ＮＳＣＬＣ患者的疗效。     

Influence of continuous infusion of interleukin-1 alpha on the core protein and the core protein fragments of the small proteoglycan decorin in cartilage.

Decorin, a collagen-binding small proteoglycan, is considered to have a specific function in the organization or stability of the collagen network. Therefore, alteration of its molecular properties may be of pathophysiological relevance during the development of cartilage damage. It is shown here that normal cartilage from rabbit knee-joint contains glycosaminoglycan chain-bearing core protein fragments of 39, 23, and 18 kDa, each one amounting to approximately 5-6% of the intact decorin core protein. Continuous infusion of human recombinant interleukin-1 alpha for 14 days (200 ng/day) into a knee-joint led in condylar cartilage to a reduction in the amount of intact core protein from 2 micrograms/mg wet tissue to about 1.1 micrograms/mg. The increase in its quantity found after infusion of heat-inactivated interleukin-1 was not statistically significant. The concentration of all three core protein fragments became reduced to a similar extent as the intact core protein under the influence of the cytokine, and additional fragments were not found. Surprisingly, there was a much smaller response to interleukin-1-treatment in patellar cartilage.     

Gd-BOPTA增强MRI对小肝癌的诊断价值

目的　比较Gd BOPTA增强MRI与MRI平扫、Gd DTPA动态增强MRI在诊断小肝癌 (SHCC)方面的差异 ,进一步提高小肝癌检出率和诊断准确性并观察其不良反应。资料与方法　手术或穿刺病理证实为SHCC患者 2 5例。采用GESigna 1.5T磁共振扫描仪。行SE序列T1WI、FSE序列T2 WI及Gd DTPA快速动态增强多期扫描。Gd BOPTA增强扫描亦采用静脉团注快速动态增强扫描 (同Gd DTPA) ,并在团注后 15min、6 0min行SE序列T1WI和FMPSPGR序列T1WI扫描各 1次。观察MRI平扫、Gd DTPA快速动态增强和Gd BOPTA增强扫描及延迟扫描对病灶的检出率、包膜显示情况以及病灶的强化特征并行统计学分析。观察其不良反应。结果　 2 5例患者共发现病灶4 2个。对SHCC病灶的检出率 ,MRI平扫为 6 9.0 5 % ,Gd DTPA增强为 85 .71% ,Gd BOPTA增强 (动态 延迟 )为95 .2 4 % ,和Gd DTPA增强之间无统计学差异 ,和MRI平扫有统计学意义。病理检查发现 30个病灶有包膜。Gd BOPTA增强对SHCC包膜的显示 ...     

准分子激光角膜原位磨镶术治疗近视合并中度以上散光疗效观察

目的 :评价小光斑飞点扫描准分子激光系统应用于准分子激光原位角膜磨镶术 (LASIK)治疗近视合并中度以上散光的疗效。　方法 :对 96例患者 14 4只眼按术前屈光度分成三组 ,Ⅰ组 75只眼 ,近视 0～ - 6D ,散光 - 2～ - 4DC ;Ⅱ组 5 7只眼 ,近视 - 6 .2 5～ 10 .0 0D ,散光 - 2～ - 4DC。Ⅲ组 12只眼 ,近视 - 10 .2 5D以上 ,散光 - 2～- 4DC ;术后随访半年以上 ,并将结果进行比较分析。　结果 :术后 1个月裸眼视力达到 0 .6以上者 ,Ⅰ组为5 .3% ,Ⅱ组为 15 .8% ,Ⅲ组为 6 6 .7% ;术后 1个月裸眼视力达到 1.0以上者 ,Ⅰ组为 94 .7% ,Ⅱ组为 84 .2 % ,Ⅲ组为 33.3%。术后半年裸眼视力达到 0 .6以上者 ,Ⅰ组为 4 % ,Ⅱ组为 14 % ,Ⅲ组为 75 % ;术后半年裸眼视力达到 1.0以上者 ,Ⅰ组为 96 % ,Ⅱ组为 86 % ,Ⅲ组为 2 5 %。术后屈光度在± 1.0D以内者 ,Ⅰ组中为 8% ,Ⅱ组为 14 % ,Ⅲ组为 5 8.3%。术后屈光度在± 0 .5 0D以内者 ,Ⅰ组为 92 % ,Ⅱ组为 86 % ,Ⅲ组为 4 1.7%。术后散光度在± 1.0DC以内者 ,Ⅰ组为 8% ,Ⅱ组为 10 .5 % ,Ⅲ组为 5 0 %。术后散光度在± 0 .5 0DC以内者 ,Ⅰ组为 92 % ,Ⅱ组为 89.5 % ,Ⅲ组为 5 0 %。平均实际切削区直径为 (8.0 2± 0 .0 6 9)mm。　结论 :使用小光斑飞点显像LASIK治疗低     

High level production of soluble single chain antibodies in small-scale Escherichia coli cultures

We have investigated the effect of growth and induction conditions on the production of soluble single-chain Fv antibody fragments in Escherichia coli under the control of wt lac promoter. The scFv was directed into the periplasmic space by a pelB leader sequence. Addition of sucrose to the medium gave a 15–25-fold increase in the yield of soluble scFv-phOx (3.0 mg/l) for bacterial shake-tube cultures and an increase of 80–150-fold (16.5 mg/l) for shake-flask cultures. Using flask culture in the presence of 0.4 M sucrose, a significant amount of scFv was released into the medium. We found that the scFv could be made to accumulate in the periplasm or be secreted into the medium by simply changing the incubation conditions and the concentration of the inducer. The ratio between soluble antibody fragments and insoluble scFv aggregates proved to be dependent on the strength of the promoter. Lowering the incubation temperature below 20°C had no effect on the yield of soluble antibody fragments in the periplasm, but they were no longer secreted into the medium. An example of high level production in shake-flask cultures and one-step purification by immobilized metal affinity chromatography (IMAC) is described for a soluble scFv specific for the T cell surface antigen CD3. The biological activity of the purified anti-CD3 scFv was demonstrated by flow cytometry. This method should be especially useful for the functional screening of a large number of clones in small-scale cultures.