羊膜移植在结膜囊成形术中的应用

目的：研究羊膜在结膜囊成形术中的应用。方法：用羊膜移植法对12例睑球粘连和13例无眼球全结膜囊缩小病例行结膜囊成形术。术中取保存羊膜，处理后将羊膜按移植所需大小制成植片，并将其按结膜囊形态与残余结膜缝合。结果：25例羊膜移植全部成活，无明显并发症。结论：羊膜取材容易，移植成活率高，是一种可供选择的有效的治疗眼表面疾患的手段。     

Severe cerebral venous sinus thrombosis and dural arteriovenous fistula in an infant with protein S deficiency

A 12-month-old infant presented with cerebral seizures and neurological deficits. MRI scan of the brain and angiography showed massive cerebral venous sinus thrombosis complicated by a dural arteriovenous fistula. Subsequent clotting analysis revealed a protein S deficiency. Screening for inherited coagulation inhibitor deficiency is recommended in children with unexplained or atypical thrombotic events. Received: 12 May 1998     

硫酸铝对小鼠胚胎组织谷胱甘肽活性和卵黄囊细胞膜流动性的影响

目的 探讨硫酸铝的发育毒性及其发生机制。方法 孕8.5d昆明小鼠胚胎于体外培养系统中给予不同剂量的硫酸铝（Al^3 浓度0.6、0.9、1.2、3.0、9.0μg/ml），培养48h后，对胚胎进行Maele-Fabry形态评分，测量卵黄囊直径，胚胎体长及头长，胚胎干重，并应用DTNB分光光度法，DPH荧光偏振技术，观察硫酸铝作用下胚胎组织谷胱甘肽（GSH）和卵黄囊细胞膜质流动性的改变。结果 当培养液中Al^3 剂量为3.0μg/ml时，胚胎生长发育和器官形态分化明显被抑制，并使畸形胚胎发生率明显升高，主要有神经管未闭，脑畸形和体屈异常；6.0μg/ml时则可致胚胎组织GSH活性和卵黄囊细胞膜质流动性显著降低。上述效应均表现出一定的剂量-效应（反应）关系。结论 硫酸铝有潜在的致畸性和胚胎毒性，这些毒性效应的发生可能与硫酸铝引起卵黄囊细胞膜流动性降低和抑制胚胎组织GSH活性有关。     

经静脉入路栓塞治疗横窦-乙状窦区的硬脑膜动静脉瘘

目的评价经静脉入路栓塞治疗横窦-乙状窦区硬脑膜动静脉瘘(DAVF)的安全性和有效性。方法经静脉入路到达患侧的横窦-乙状窦,用微弹簧圈填塞病变静脉窦,同时闭塞瘘口。结果经静脉入路治疗横窦-乙状窦区DAVF共16例。病变累及横窦-乙状窦交界处者11例、横窦者3例、乙状窦者2例。根据Cognard分类,IIa型3例,IIb型1例,IIa b型12例。单纯应用静脉入路7例,经静脉入路前先采用经动脉途径栓塞者8例,经静脉入路栓塞治疗后再经动脉途径栓塞者1例。瘘口完全闭塞13例,瘘口残留3例,但瘘口流量已减少95%以上。15例(94%)在栓塞治疗后临床症状消失,1例栓塞后出现颅内出血死亡,未见其他并发症。随访4～23个月,临床症状无复发。11例行造影复查:3例残留瘘口者2例消失,1例曾行3次造影复查瘘无明显变化,由于无临床症状,未再行栓塞治疗;另外8例造影复查未见复发。结论对于适当选择的横窦-乙状窦区DAVF病例,经静脉入路闭塞病变静脉窦是一种安全有效的治疗方法。     

脑磁共振静脉成像

目的：磁共振静脉成像(MRV)已被广泛应用于颅内静脉系统检查，特别是用来评价静脉窦血栓形成。本研究的目的是评价脑MRV描述正常颅内静脉系统解剖和变异的作用，评价它在诊断硬脑膜窦血栓形成过程中潜在的误诊因素。材料和方法：对79例常规磁共振表现正常的MRV图像进行分析，观察硬脑膜窦和主要静脉的表现和缺失情况。其中7例志愿者接受了MRV和3DPCMRA两种方法检查。结果：上矢状窦、直窦、Galen静脉和大脑内静脉显示率为100％，枕窦显示率为10％，基底静脉显示率为92％。横窦血流间隙显示率约为34％，均出现在非优势侧横窦，优势侧横窦没有出现流动间隙。结论：MRV是有效的评价颅内静脉系统方法。常规MR表现正常者中有34％可以发现横窦流动间隙，这些流动间隙不应被误诊为静脉窦血栓形成。     

Closed lesser sac lavage in the management of pancreatic necrosis

BACKGROUND AND AIM: Surgery for pancreatic necrosis complicating acute severe pancreatitis carries a high risk of morbidity and mortality. We evaluated the efficacy of necrosectomy and closed lesser sac lavage as a method of management of pancreatic necrosis. METHODS: Fifty-eight patients with pancreatic necrosis who underwent pancreatic necrosectomy consecutively in a tertiary care referral center were retrospectively analyzed. The technique of necrosectomy and postoperative lavage is described in detail. Details regarding the patient profile, disease severity, surgical details, postoperative morbidity, repeat interventions and the mortality are presented. RESULTS: Of the 58 patients, irrigation was able to be started in 48. Lavage was able to be continued until disease resolution or death in all but 10 patients. Post-operative locoregional complications were residual abscesses in 10, bleeding in eight, enteric fistulae in 12 and pancreatic fistulae in nine. Six patients needed postoperative percutaneous procedures, while 16 patients needed repeat surgery. Seventeen patients died (29%), all of whom had multiple organ failure involving more than two organs, while 11 developed sepsis. CONCLUSION: Pancreatic necrosectomy and postoperative closed lesser sac lavage is an effective method of managing these patients, with acceptable morbidity, re-operation rates and mortality.     

Multidisciplinary treatment of primary intracranial yolk sac tumor: A case report and literature review

Rationale:Intracranial yolk sac tumors (YSTs) are rare malignancies with limited treatment options and a dismal prognosis. They are usually managed with surgical resection and chemoradiotherapy.Patient concerns:Here, we report a patient with primary YST in the pineal region who achieved long term survival. Despite undergoing treatment, he experienced several recurrences over a 15-year period.Diagnosis:Brain magnetic resonance imaging (MRI) demonstrated the presence of space-occupying lesions in the pineal region and the medial tail of the left lateral ventricle. The tumors were excised, and the histological diagnosis suggested an intracranial YST.Interventions:The patient achieved long term survival after combined modality therapy including surgery, stereotactic radiosurgery (SRS)/intensity modulated radiation therapy (IMRT), chemotherapy, and targeted therapy.Outcomes:The disease remained stable. However, the patient gave up treatment and passed away in October 2020, with a total survival of about 15 years.Lessons:To the best of our knowledge, this patient with intracranial YST had received a longer survival compared with other published reports. We summarize previously published reports of intracranial YST and discuss the importance of multidisciplinary treatment. SRS may have a role, as a focal boost to residual tumor after resection or in case of recurrence after conventional radiotherapy, in the multimodality management of intracranial YSTs.     

High aneurysm wall enhancement values are associated with late sac shrinkage after endovascular repair of abdominal aortic aneurysms

To analyze the correlation between aneurysm wall enhancement (AWE) values and early and late sac shrinkage after endovascular aneurysm repair (EVAR).We retrospectively analyzed 28 patients who underwent EVAR for abdominal aortic aneurysms (AAA) using a bifurcated main body stent graft. The value of AWE in the slice of the maximum AAA diameter was measured using a volumetric analysis of computed tomography images. Sac measurements before EVAR and more than 10 months after EVAR were compared, and the maximum sac shrinkage rate was calculated.The AWE value immediately after (4 to 7 days) EVAR correlated positively with the sac shrinkage rate (R² = 0.0139). The AWE value at 6 months after EVAR was also strongly correlated with the sac shrinkage rate (R² = 0.4982).Higher AWE values at 6 months after EVAR were strongly associated with the sac volume shrinkage rate. High AWE values may be a predictive factor for sac shrinkage and may aid in the selection of the appropriate clinical strategy after EVAR.     

Association of <Emphasis Type="Italic">cagA</Emphasis> Positive <Emphasis Type="Italic">Helicobacter pylori</Emphasis> Infection and Laryngeal Squamous Cell Carcinoma: A PCR Approach

Helicobacter pylori is a gram-negative bacillus causing benign and malignant gastric diseases such as gastroesophageal reflux (GER). In larynx, H. pylori causes chronic inflammation and mucosal destruction that may lead to malignant changes. Although, H. pylori poses several virulence factors, cagA is probably the main factor in this regard. To evaluate the role of cagA gene in laryngeal squamous cell carcinoma (LSCC), a case–control study was conducted on patients with laryngeal complaints during 2010–2012. Seventy-two patients with LSCC (case group) and 72 patients without malignancy (control group) were included in the study. The H. pylori and cagA factor were assessed in laryngeal specimen of patients with PCR technique. 33 % of patients in case group (24 patients) and 45.8 % (33 patients) of control group were positive for H. pylori. CagA gene was present in 13.8 % (10 patients) of case group specimens and 31.9 % (23 patients) of control group. This difference was statistically significant with Mantel–Haenszel statistical test analyses. The results showed that patients with LSCC have significantly lower incidence of laryngeal H. pylori infection and cagA virulence factor than those without LSCC. Findings from this study support the protective effect of H. pylori infection against laryngeal cancer.