Recurrent acute renal failure due to a rectal villous adenoma

A case is reported in which a rectal villous adenoma was complicated by severe fluid and electrolyte depletion producing recurrent renal failure. The pathophysiology of the depletion syndrome and its complications are discussed. Successful management by acute haemodialysis and early surgical resection of the tumour is described.     

Galactorrhoea amenorrhoea syndrome due to internal carotid artery aneurysm

A 32 year old female with hyperprolactinaemia-galactorrhoea-amenorrhoea due to a right internal carotid artery aneurysm just before its bifurcation is described. She had two episodes of subarachnoid haemorrhage necessitating an emergency internal carotid artery ligation. She responded to bromocriptine treatment with restoration of her menses, normalization of circulating prolactin and disappearance of galactorrhoea.     

结扎股动脉治疗注射毒品所致假性股动脉瘤体会

目的：探讨结扎股动脉在治疗注射毒品所致假性股动脉瘤中的优缺点方法：运用结扎股动脉术对16例注射毒品所警假性股动脉瘤患者的临床资料进行回顾分析结果：16例患者全部保肢成功,术后复查彩色多普勒显示远端血管充盈。结论：在患者不能采用合适的自体大隐静脉移植及人造血管移植时,股动脉结扎术是治疗注射毒品所致假性股动脉瘤的有效方法之一。     

Colonic bleeding due to rupture of an isolated iliac artery aneurysm into a caecal carcinoma

We describe a case of a fistula between an atherosclerotic aneurysm of the right common iliac artery and a caecal carcinoma, causing massive colonic bleeding. A fistula between a true aneurysm and a carcinoma of the colon has not to our knowledge been previously reported. Various aspects of this case are discussed from a pathogenetic point of view.     

Recurrent hemiplegia due to hypoglycaemia

A case of recurrent hemiplegia resulting from hypoglycaemia associated with a large thoracic fibrosarcoma, and the satisfactory response to removal of the tumour, is described. The possible causes of the hypoglycaemia are discussed.     

A case of vagal palsy due to dissecting aneurysm of the carotid artery

A case of unilateral vagus palsy due to spontaneous painless dissection of the left internal carotid artery is reported. The anatomy of the extracranial course of the vagus nerve and the differential diagnosis of unilateral vagal palsy are discussed.     

重症急性胰腺炎肝损伤机制的研究进展

重症急性胰腺炎（SAP）是临床常见急腹症之一,有起病急、进展快、致死性并发症多的特点。急性胰腺炎并发胰腺外器官损伤已成为近年来临床和基础研究的一大热点和难点。现就急性胰腺炎并发肝损伤机制的研究进展作一综述。     

重症急性胰腺炎合并腹内高压的临床治疗及观察

目的:探讨重症急性胰腺炎合并腹内高压的临床治疗。方法:选取收治的重症急性胰腺炎合并腹内高压患者176例作为本次研究的对象,将患者随机分成对照组与研究组,对照组予以常规治疗,研究组在对照组基础上采用乌司他丁治疗。结果:治疗后研究组患者的IAP、DAO、Ig A、IL-6以及TNF-α水平改善情况要明显优于对照组与治疗前;研究组临床总有效率是97.73%,对照组临床总有效率是79.55%,组间临床疗效对比具有显著性差异。结论:重症急性胰腺炎合并腹内高压患者在常规治疗基础上辅以乌司他丁治疗,能够明显改善腹内高压,提高临床疗效,值得在临床上大力推广。     

生长抑制激素和生长激素对急性坏死性胰腺炎肝损伤的保护作用

目的探讨生长抑制激素（简称生长抑素）和生长激素对急性坏死性胰腺炎（ＡＮＰ）肝损伤的保护作用。方法３５％牛磺胆酸逆行胰胆管注射,建立ＡＮＰ大鼠模型。观察炎性介质［内毒素、淀粉酶、肿瘤坏死因子α（ＴＮＦα）］的变化并用逆转录多聚酶链反应（ＲＴＰＣＲ）分析ＴＮＦαｍＲＮＡ转录水平的表达,及生长抑素和生长激素的治疗作用。结果ＡＮＰ可以诱导炎性介质明显升高,并与肝损伤的严重程度呈正相关,而且肝的ＴＮＦαｍＲＮＡ也呈高表达。生长抑素和生长激素能抑制ＡＮＰ的炎性介质过度释放及肝ＴＮＦαｍＲＮＡ的转录水平的高表达,减轻胰腺和肝的损伤程度。结论炎性介质参与了ＡＮＰ对肝脏的损伤,生长抑素和生长激素对ＡＮＰ的肝损伤保护有协同作用     

Changes in hepatic energy metabolism in experimental acute pancreatitis.

The changes in the cellular concentrations of ATP, ADP, AMP and oxidative phosphorylation of mitochondria in the liver were investigated experimentally in rats with acute pancreatitis (AP). The energy charge (ATP + 1/2ADP)/(ATP+ ADP+ AMP) of the liver decreased from 0.866 to 0.806 (P < 0.05) at 24 hours after onset of AP, and continuously decreased to 0.769 (P < 0.01) at 48 hours. On the other hand, the mitochondrial phosphorylative activity increased rapidly to 130% and 157% in the controls at 12 hours and 24 hours respectively and then decreased rapidly at 48 hours. The blood ketone body ratios were paralleled to the hepatic energy charge level in AP rats. These findings suggest that the nature of the derangement of the hepatic energy metabolism initiated by AP is that the effects of mitochondria damage result in a significant decrease in liver energy charge level, leading ultimately to hepatocellular impairment, and the measurement of the blood ketone body ratio is useful in evaluating the energy status of the liver in AP patients.