Electric shock wave lithotripsy (ESWL) as a pain control measure in dermatomyositis with calcinosis cutis—old method, new discovery

A 23-year-old Chinese man with dermatomyositis associated calcinosis cutis received electric shock wave lithotripsy (ESWL) as an alternate to a conventional pharmacological regimen to reduce pain associated with the complications of subcutaneous calcinosis nodules. He became symptom and opioid free after two courses of ESWL. No significant adverse effect had been noted. ESWL may serve as a means of pain killing in patients suffering from debilitating pain caused by complicated calcinosis cutis.     

消旋棉酚拆分的研究——Ⅱ.手性α-甲基苯乙胺及α-甲基苄胺为拆分剂

本文报道用中压柱色谱快速分离S或R-α-甲基苯乙胺及S或R-α-甲基苄胺缩(±)-棉酚的方法,可得光学活性胺缩( )或(一)-棉酚非对映体,经水解分别得到( )或(一)-棉酚。并证明胺缩光学活性棉酚非对映体之间有互相转化的性质,此特性可利用于棉酚对映体的转化。     

A novel system for providing compatible blood to patients during surgery: "self-service" electronic blood banking by nursing staff

BACKGROUND: A good blood bank must be able to provide compatible blood units promptly to operating room patients with minimal wastage. A "self- service" by nursing staff blood banking system that is safe, efficient, and well-accepted has been developed. STUDY DESIGN AND METHODS: Specific blood units are no longer assigned to surgical patients who have a negative pretransfusion antibody screen, irrespective of the type of surgery. A computer-generated list of the serial numbers of all group-identical blood units currently in the blood bank inventory is provided for each patient. The units themselves are not labeled with a patient's name. The group O list will be provided for group O patients, the group A list for group A patients, and so forth. Should the patient require transfusion during surgery, the operating room nurses go to the refrigerator, remove any group-identical unit, and check the serial number of the unit against the serial numbers on the patient's list. If the serial number is on that list, the blood bank will accept responsibility for compatibility. The system was implemented in 1995. RESULTS: Since implementation, a total of 2154 patients have undergone operations at this hospital. Thirty-two patients received more than 10 units of red cells each. There were no transfusion errors. The crossmatch-to-transfusion ratio was reduced from 1.67 to 1.12. Turnaround time for supplying additional or urgent units to patients in operating room was shortened from 33 to 2.5 minutes. There was no incidence of a blood unit's serial number not being on the list. Work by nurses and technical staff was reduced by nearly 50 percent. CONCLUSION: The "self-service" (by nursing staff) blood banking system described is safe and efficient. It saves staff time and can be easily set up.     

B超引导下集束电极射频治疗小肝癌

0　引言　肝癌恶性程度高 ,早期症状无特异性 ,手术切除率低 ,术后复发率高 .在我国多数患者一经发现已属中晚期且伴有显著肝硬化 ,不能承受肝切除 ,宜以综合性治疗为主 .我院自 1999年 5月开展 B超引导下多弹头射频治疗肝癌以来 ,已收治肝癌患者 2 5 0余例 ,现总结其中 45例小肝癌患者的治疗情况报告如下 .1　对象和方法1.1　对象　 1999- 0 5 / 12在我院肝病中心接受集束电极射频治疗的小肝癌患者 (瘤体直径 <5 cm) 4 5 (男 33,女 12 )例 ,年龄 2 1～ 6 8岁 .有肝炎病史 37例 ,血 AFP>2 0 ng· L- 1 2 2例 ,伴肝硬变者 36例 .入院前有介…     

构建肠系膜微淋巴管内皮细胞培养技术并观察休克淋巴液环境中内皮细胞的形态变化

目的:建立肠系膜微淋巴管内皮细胞的培养技术,观察不同体积分数的休克淋巴液对大鼠肠系膜微淋巴管内皮细胞形态的影响。方法:实验于2004-02/07在河北北方学院病理生理学教研室及实验中心细胞培养室完成。选择健康雄性Wistar大鼠,体质量分别为220～300g和50～80g。实验方法:①无菌条件下制备大鼠重症失血性休克模型,引流肠系膜淋巴液或收集门静脉血;同时另取大鼠,引流正常淋巴液或正常门静脉血。②从动物种类、培养基、植块方法、胎牛血清浓度等方面对植块培养法进行改良,进行肠系膜微淋巴管内皮细胞原代培养并传代。实验分组:分为6组:胎牛血清组:培养液为DMEM 体积分数为0.1的胎牛血清;正常淋巴液组:培养液为DMEM 正常淋巴液;休克淋巴液组:培养液为DMEM 体积分数为0.04,0.06,0.08,0.10的休克淋巴液;正常血浆组:培养液为DMEM 正常血浆;休克血浆组:培养液为DMEM 休克血浆;无血清对照组:培养液为DMEM。实验评估:①光镜下观察大鼠肠系膜微淋巴管内皮细胞原代培养及传代情况。②光镜、扫描电镜及透射电镜下观察不同体积分数的休克淋巴液及不同作用时间(4,8,12h)对肠系膜微淋巴管内皮细胞形态及超微结构的影响。结果:①光镜下肠系膜微淋巴管内皮细胞原代培养及传代情况:内皮细胞呈扁平的梭形或多边形,大小均匀,胞核清晰,呈卵圆形。细胞生长融合形成单层后,呈典型的鹅卵石或铺路石样镶嵌状排列生长。②光镜下在休克淋巴液中肠系膜微淋巴管内皮细胞形态:体积分数为0.04的休克淋巴液作用4h时细胞逐渐收缩、变圆直至脱落漂浮,随着休克淋巴液体积分数增加及作用时间延长,细胞损伤逐渐加重,体积分数为0.08的休克淋巴液作用4h时核旁出现空泡,体积分数为0.10的休克淋巴液作用12h时细胞裂解成碎片。其他各组作用12h肠系膜微淋巴管内皮细胞形态无显著改变。③扫描电镜下在休克淋巴液中肠系膜微淋巴管内皮细胞形态:体积分数为0.04的休克淋巴液作用4h部分细胞逐渐收缩离壁,细胞间隙增大、细胞边缘的突起拉长、缩短、断裂,作用8,12h可见凋亡小体。其他各组作用12h肠系膜微淋巴管内皮细胞形态无显著改变。④透射电镜下在休克淋巴液中肠系膜微淋巴管内皮细胞形态:体积分数为0.04的休克淋巴液作用4h细胞膜形态不规整,胞浆内质网等膜性细胞器扩张,核形态不规则,作用8h线粒体呈球形扩张,细胞核逐渐出现固缩、似细胞凋亡改变,核周腔变宽;体积分数为0.08的休克淋巴液作用时间8h细胞内出现囊泡,内质网不同程度扩张,线粒体主要表现为浓缩、深染等改变,细胞膜边界不清,出现起泡、破碎等现象。其他各组作用12h肠系膜微淋巴管内皮细胞形态无显著改变。结论:成功建立了肠系膜微淋巴管内皮细胞的培养技术;休克淋巴液可导致肠系膜微淋巴管内皮细胞形态及超微结构损伤。     

Tumor growth-promoting cellular host response during liver atrophy after portal occlusion.

BACKGROUND/AIMS: Clinical observations suggest cancer progression after preoperative segmental portal vein occlusion, a procedure to prevent liver failure after major hepatic resections. The aim of this study was to determine whether portal occlusion induces host reactions which promote cancer invasion and angiogenesis. METHODS: The rat model of portal branch ligation (PBL) was compared with partial hepatectomy (PH) and sham operation (SO) and evaluated for the expression of heat shock protein-70 (hsp70), heme oxygenase-1 (hmox1), early growth response gene-1 (Egr-1) and urokinase-type plasminogen activator (uPA), its inhibitor (PAI-1) and receptor (uPAR). RESULTS: Portal deprivation after PBL was associated with a regression of liver tissue to 25% of its original mass within 8 days with only modest fibrotic changes. During the progression of atrophy, there were significant inductions of hsp70-, hmox1- and Egr-1-mRNA in comparison with regenerating liver tissue. PAI-1-specific mRNA was transiently elevated at 3 - 48 h after PBL in the atrophying lobes, whereas uPA and uPAR were unaffected in comparison with PH or SO. CONCLUSION: Hepatic atrophy caused by PBL is associated with increased expression of genes known to promote tumor growth. These host events represent a possible explanation for the tumor progression after portal occlusion and require further evaluation.     

Fibromuscular dysplasia of the renal arteries: a radiological review

Fibromuscular dysplasia is the most common cause of renovascular hypertension in young patients. Digital subtraction angiography is still the best investigation used to determine the location, extent and complication of renal artery involvement. String of beads appearance (reflecting multiple stenoses), aneurysms, focal or tubular stenosis are classic angiographic appearances. The aim of this pictorial essay is to illustrate the various imaging findings of renal artery fibromuscular dysplasia.