A primary gastric Burkitt's lymphoma in a child]

We report a case of a primary gastric Burkitt's lymphoma in a 8-year-old child, which first symptoms were abdominal pain, dysphagia, melena and a constitutional syndrome. The differential characteristics of this case are its peculiar gastric infiltration and the existence of oesophageal extension, which is very infrequent among this kind of tumors.     

急性脑梗死后血浆NO、NOS、ET含量的动态变化及尼莫地平对其影响

目的　观察急性脑梗死 (ACI)后血浆一氧化氮 (NO)、一氧化氮合成酶 (NOS)、内皮素 (ET)含量的动态变化 ,以及尼莫地平治疗后对其影响。方法　ACI患者 110例 ,随机分成尼莫地平组 (5 0例 ) (在常规治疗基础上用尼莫地平 )和常规治疗组 (6 0例 )。在发病后不同时点动态观察血浆NO、NOS、ET含量 ,并设 5 0例脑动脉硬化患者为对照组。结果　脑梗死后血浆ET含量显著升高 ,直至恢复期 ;NO、NOS先增高后下降 ;尼莫地平组和常规组比较ET有显著差异 (P <0 .0 1) ,NO、NOS差别不显著 (P >0 .0 5 )。结论　NO、NOS、ET参与并影响了ACI后复杂的病理生理过程 ;尼莫地平部分通过对ET含量的影响发挥其对脑梗死的治疗作用     

母亲苯丙酮尿症后代的脑MRI表现

目的 提高对母亲苯丙酮尿症(MPKU)后代脑MRI表现的认识。资料与方法 报告2例生化及临床检查证实为MPKU双胞胎的．MRI改变，并复习文献。结果 文中2例表现与文献报道不一致．与苯丙酮尿症患儿的表现相似。常规T2WI及FLAIR均显示室周白质、侧脑室三角区、半卵圆中心条片状高信号。弥散加权成像(DWI)除更清楚地显示上述改变外，尚显示双侧内囊后肢及胼胝体压部信号增高。结论 常规T2WI及FIJAIR上可显示MPKU后代脑白质异常，DWI可提供更多诊断依据。     

原发性输尿管癌31例临床分析

目的：提高原发性输尿管癌的术前诊断水平。方法：对南京医科大学第一附属医院1989-2002年间收治的31例原发性输尿管癌的临床资料进行回顾性分析。结果：31例中，肉眼血尿22例(71．0％)，腰痛11例(35，5％)。B超、静脉肾盂造影(IVU)、CT和逆行造影检查的阳性率分别为输尿管腔内占位4例(13．0％)、输尿管腔内占位3例(11．5％)、膀胱或合并膀胱占位8例(36．4％)，输尿管充盈缺损6例(40．0％)。29例患者经手术治疗，其中13例行患侧肾、输尿管、膀胱袖状切除。结论：老年患者反复发作的腰痛及血尿应考虑原发性输尿管癌的可能，造影诊断对本病有较高价值，应作CT及MRU无创检查。     

重组2型腺相关病毒-转化生长因子β3对实验性肝纤维化大鼠肝脏组织病理学和Ⅰ型胶原表达的影响

Objective To investgate the effects of TGF β 3 on rat hepatic fibrosis. Methods The TGF β 3 cDNA was cloned into rAAV2 vector. Rats were randomly divided into four groups: normal control group, model group, negative control group and TGF β 3 group. Hepatic fibrosis was induced by hypodermic injection of 40% CCI4. Recombinant AAV2-TGF β 3 viral particles were injected via the vena caudalis one week before CCh treatment. Rats were executed 8 weeks after CCI4 treatment, global histological change was observed after HE staining, the distribution of the collagen fibers was observed after masson staining, his-tochemistry was done to observe the expression of collagen Ⅰ; The positive area rate of the collagen fibers and the average optical rate of collagen Ⅰ were quantified. Results HE staining indicated that collagen fibers were reduced in the TGF β 3 group. Masson staining shown that the collagen fibers were distributed around the blood vessel, in the portal area and disse space. Compared to the model group (13.2%±2.2%) and negative control group (12.3%±1.5%), the collagen fibers in liver tissues of TGF β3 group (7.7% ± 1.5%) were significantly decreased (q = 9.456, P < 0.01; q = 8.217, P < 0.01). Histochemistry indicated that the collagen fibers of liver tissues of TGF 15 3 group (0.185±0.033) were significantly higher than those in the model group (0.252±0.042) and the negative control group (0.230±0.029), (q = 6.228, P < 0.01; q = 4.346, P < 0.01). Conclusion TGF β 3 alleviates the damage to hepatic cell and the level offibrosis in CCI4 treated rats and inhibits the expression of collagen Ⅰ.     

ApoMT对CdMT肾毒性保护作用研究

本文研究了去除金属离子的金属硫蛋白（ApoMT）对镉金属硫蛋白（CdMT）肾毒性作用的影响。结果发现，与单独给予CdMT比较，ApoMT能降低尿蛋白量和尿碱性磷酸酶（AKP）活性，并能促进尿Cd的排泄。肾组织形态学结果显示肾近曲小管损伤程度明显减轻。提示ApoMT对CdMT肾小管损伤具有保护作用。     

文拉法辛与三环类抗抑郁药治疗抑郁症痊愈率的循证医学研究

目的　比较文拉法辛与三环抗抑郁药治疗抑郁症临床痊愈率的差异。方法　应用循证医学的Me-ta分析,采用固定效应模型(fixed effects model,FEM)法对符合标准的16项对照研究文献进行评价。结果　文拉法辛与三环抗抑郁药治疗抑郁症的临床痊愈率不同,差异有显著性(χ2=4.773,df=1,P<0.05);综合的ORs=1.36,95%CI为1.04~1.78。提示文拉法辛治疗抑郁症的临床痊愈率是三环抗抑郁药的 1.36倍。结论　治疗抑郁症,文拉法辛比三环抗抑郁药有更可靠的临床痊愈率。     

电视硬质气管镜治疗大气道良性肿瘤

目的探讨电视硬质气管镜在大气道良性肿瘤治疗中的价值.方法2002年9月～2005年4月,我院应用电视硬质气管镜治疗大气道良性肿瘤7例,其中气管1例,隆突1例,左主支气管3例,右主支气管2例.手术采用静脉全身麻醉,喷射通气供氧,探查评估气道后,首先冷冻或电凝肿瘤,破坏肿瘤血供,再以活检钳分块取出,蒂部采用冷冻或氩气凝固处理;对于宽蒂肿瘤,内镜下将肿瘤主体清除后中转开胸行气管局部切除吻合术.结果7例手术均顺利,无一例死亡和严重并发症发生.6例气管窄蒂良性肿瘤镜下完整摘除,1例气管膜部宽蒂平滑肌瘤先内镜清除肿瘤主体后中转开胸行气管局部切除.术后病理为错构瘤2例,平滑肌瘤3例,嗜酸性肉芽肿性腺瘤1例,炎症组织1例.7例随访3～36个月,平均17.3月,无肿瘤复发.结论电视硬质气管镜治疗大气道良性肿瘤安全可靠.     

汶川大地震后送伤病员病情特点及救治要点

2008年5月12日发生的汶川里氏8．0级地震造成37万余人受伤，近90％为肢体创伤病员。其中，10％-15％患者伴有颅面、胸腹部等处创伤。我院于2008年5月23日及28日分两批收治47名震区空运伤病员，其中骨科伤病员41例。本文针对我院接收的41例骨科伤病员的入院时病情特点、治疗措施及原则等作一简要总结。