43例回盲部恶性肿瘤的CT 影像学诊断

[目的]探讨回盲部常见恶性肿瘤的CT影像学表现。[方法]收集经手术病理证实的43例回盲部恶性肿瘤,对其CT表现作回顾性分析。[结果]43例回盲部恶性肿瘤中腺癌26例,多数CT表现为偏心性肿块或肠管局限性增厚,密度不均,中度或明显强化,浆膜面浸润;淋巴瘤7例,CT表现为肠壁弥漫性增厚或腔内息肉样肿块,密度均匀,轻中度强化;转移瘤3例,CT表现为不规则软组织块,无特异性;恶性间质瘤3例,CT表现为类圆形肿块,密度欠均,周边明显强化;平滑肌肉瘤2例,CT表现为较大混杂密度块,实质部分明显强化;类癌2例,CT表现为阑尾中远端显著强化小肿块。[结论]回盲部恶性肿瘤类型多样,CT表现具有一定的特征性,熟悉CT影像学表现有助于诊断与鉴别诊断,为临床治疗提供大量信息和依据。     

中国北方人颅面发育测量研究(二)

中国北方人颅面发育测量研究（二）郝允荣陈国璋庄强寇星灿文中报告北京地区中国北方人颅面发育测量研究中眶和鼻的测量数据及发育情况。材料和方法调查对象１８０名北京地区６岁、１２岁和１８岁健康男女青少年，每一年龄段分为男女两组各３０名。测量仪器和测量点的选择...     

颅咽管瘤术后钠代谢紊乱21例分析

目的 分析颅咽管瘤切除术后钠代谢紊乱与肿瘤部位及切除程度的相关性.方法 对我院2006年2月至2010年10月30例颅咽管瘤手术切除术后发生钠代谢紊乱的21例患者的临床资料进行回顾性分析.结果 30例患者中术后出现高钠血症10例,低钠血症9例,高钠、低钠交替出现2例.死亡1例.肿瘤部位与术后发生钠代谢紊乱情况:鞍内未发生,鞍内-鞍上8例(61.5%,8/13),鞍后鞍旁3例(60.0%,3/5),三脑室及侧脑室10例(100.0%,10/10);肿瘤部位与术后发生钠代谢紊乱有关(x2=9.63,P<0.05).肿瘤切除程度与术后出现血钠异常情况:全切除患者发生血钠异常15例(62.5%,15/24),次全切除4例(100.0%,4/4),部分切除2例(100.0%,2/2)),肿瘤切除程度与术后出现血钠异常无关(x2=3.21,P>0.05).结论 颅咽管瘤切除术后钠代谢紊乱可能与肿瘤的部位有关,而与肿瘤的切除程度无关.

Abstract：

Objective To analyze the correlation between the position and the removal extent of the tumor and the postoperative sodium metabolic disturbance in patients with craniopharyngiomas. Methods Retrospective analysis of the postoperative sodium metabolic disturbance in craniopharyngioma patients admitted from Feb.2006 to Oct. 2010 was performed. Results In the 30 casese,10 cases occurred hypernatremia,9 with hyponatremia and, 2 with fluctuating hyponatremia and hypematremia. One cases died in the population. No sodium metabolic disturbance occurred in patients with craniopharyngiomas located in the interasellar region, whereas 8 occurred in the inter and suprasellar region(61.5% ,8/13) , and 3 occurred post and beside assellar region(60.0% ,3/5) , 10 occurred in the third and lateral cerebral ventricle (100.0%, 10/10). Sodium metabolic disturbance occurred in 15 cases(62. 5% ) among 24 cases underwent total resection,in all 4 cases underwent sub-total resection (100.0% ) ,and all 2 cases underwent paritical resection ( 100. 0% ). The degree of resection was not correlated with Sodium metabolic disturbance(x2 = 3.21 ,P>0.05). Conclusion Sodium metabolic disturbance after craniopharyngioma surgery may be correlated with the position of tumor, but not correlated with the removal extent.     

交锁髓内钉结合骨屑植骨治疗股骨干多段骨折的效果分析

目的 探讨交锁髓内钉结合骨屑植骨治疗股骨干多段骨折的效果.方法 选择本院35例股骨干多段骨折患者,给予交锁髓内钉复位内固定,并将扩髓产生的骨屑植于骨折断端间或周围,术后视病情进行功能锻炼.结果 本组35例患者术后平均随防15.6个月,31例骨性愈合,3例延迟愈合,1例骨不连,整体效果满意.结论 交锁髓内钉结合骨屑植骨治疗股骨干多段骨折,符合人体生物力学特点,固定可靠,并发症少,效果较好.     

嵌钝性假牙误入胃内1例分析

对嵌钝性假牙误入胃内1例分析如下.1病历摘要男,72岁.因误咽假牙12 h入院,其前日晚餐时误咽假牙,当时觉咽喉部疼痛梗阻感,无咳嗽、呼吸困难等,自行处理无效后来我院耳鼻咽喉科就诊.查:老年男性,痛苦貌,无明显口内流涎.口咽及喉咽部未见异物,梨状窝少量唾液潴留,声门区未见异常,颈部周围未及气肿及触痛.行颈侧位片检查:第7颈椎前方见金属丝状影.急诊行胃镜取异物,因假牙边缘金属钩嵌入食管黏膜无法拉出而失败.当晚嘱患者禁食,拟翌日采用食管镜行异物取出术,术前常规行正位胸片等检查后进人手术室.术中食管镜进镜至食管人口处时未见异物,继续深入到食管贲门处亦未及异物,考虑异物进入胃内,行X线拍片见食管走行径路未见异物,术中再次仔细阅读术前正位胸片发现胸椎前胃区有金属影,遂结束手术.第3天患者诉假牙已经大便排出体内.     

全身照射后肠黏膜通透性与肠三叶因子mRNA表达的关系

目的 探讨全身照射(TBI)对肠道黏膜通透性和肠三叶因子(ITF)mRNA表达的影响以及二者之间的关系.方法 32只BALB/c小鼠随机均分为4组:空白对照组和总剂量8.0 Gy全身照射后4、8和12 d组.TBI剂量8.0 Gy,剂量率1.0 Gy/min.高效液相色谱-蒸发光散射检测器分析(HPLC-ELSD)检测尿液标本中乳果糖与甘露醇的排出率比值(L/M),评价各组小鼠的肠道通透性;收集空肠组织标本,实时荧光定量PCR检测肠道ITF mRNA表达水平.结果 TBI后4、8和12d组L/M比值分别为0.5092±0.0353,0.7174±0.0116和0.7295±0.0063,均明显高于空白对照组(0.2908±0.0533,F=321.47,P＜0.05).TBI后4、8和12 d组ITF mRNA表达水平分别为0.78612±0.1428,0.2521±0.1223,和0.2306±0.0221,均显著低于空白对照组(1.3498±0.0476,F=235.71,P＜0.05).各TBI组中L/M与肠道ITF mRNA水平呈显著负相关(r=-0.985,P＜0.01).结论 TBI后随着时间延长ITF mRNA表达逐渐下降而肠黏膜通透性逐渐增加,即TBI后ITF mRNA表达与肠道通透性呈显著负相关.ITF在TBI所致肠道黏膜通透性增加中起着保护作用.

Abstract：

Objective To investigate the change of the intestinal permeability,the expression level of intestinal trefoil factor (ITF) mRNA and the relationship between them after total body irradiation (TBI),and explore the effect of TBI on the development of intestinal permeability and the expression level of ITF mRNA.Methods Twenty two BALB/c mice were randomly divided into 4 equal groups: 3 groups at 4,8 and 12 d after TBI with the total dose of 8.0 Gy and the dose rate of 1.0 Gy/min respectively,and a control group.Lactulose (L) and mannitol (M) were perfused into the esophagus before the experiment and urine samples were collected.Liquid chromatography was used to measure the L/M excretion ratio in the urine samples collected 4,8,and 12 days after the TBI.And then the mice were killed with their intestine were taken out.The expression of ITF mRNA in the jejunum tissue was detected by real-time fluorescence quantitative PCR.Results The urine L/M ratio levels of the groups 4,8 and 12 days after TBI were (0.5092 ± 0.0352),(0.7174 ± 0.0116),and (0.7295 ± 0.0533) respectively,all significantly higher than that of the control group [(0.2908 ± 0.0533),F = 321.47,P ＜ 0.05].The ITF mRNA expression levels of groups 4,8 and 12 days after TBI were (0.78612 ±0.1428),(0.2521 ±0.1223),and (0.2306 + 0.0221 ) respectively,all significantly lower than that of the control group [( 1.3498 + 0.0476),F = 235.71 ,P ＜ 0.05].The urine L/M ratio was significantly negatively correlated with the expression of ITF mRNA in all TBI groups (r = - 0.985,P ＜ 0.01 ).Conclusions The intestinal permeability increases and the expression level of ITF mRNA decreases after TBI.The urine L/M ratio is negatively correlated with the expression level of ITF mRNA after TBI.ITF is involved in protection against intestinal permeability induced by TBI.     

白介素-11对小鼠异基因骨髓移植后aGVHD的预防作用

目的 评估白介素-11(Interleukin-11,IL-11)对小鼠异基因骨髓移植(allo-BMT) 后急性移植物抗宿主病(aGVHD) 的预防作用. 方法 用主要组织相容性抗原(MHC) 完全不合的纯种近交系SPF级小鼠,雄C57BL/6(H-2b)为供鼠,雌性BALB/C(H-2d)为受鼠,建立allo-BMT/aGVHD 动物模型,随机分3组:模型对照组、IL-11组(剂量为500μg/(kg·d)、环孢菌素A(CsA)组(剂量为10mg/(kg·d),观察其对aGVHD 的预防作用. 结果 IL-11组、CsA组受鼠生存时间均长于模型对照组(P<0.01);IL-11组、CsA组受鼠aGVHD临床表现和病理改变均较模型对照组明显轻.IL-11组、CsA组之间平均生存时间比较无统计学差异(P=0.901). 结论 IL-11可有效预防小鼠allo-BMT后aGVHD,减轻其症状和病理损害程度,显著延长平均生存时间.     

先天性耳前瘘管感染期手术治疗56例临床分析

先天性耳前瘘管是儿童常见病,感染后传统方法是先予抗感染治疗,有脓肿形成的先切开引流、换药,待感染灶皮肤恢复正常才考虑手术切除,但有的患者经长时间抗炎治疗和换药仍无法彻底控制感染.我科2005年1月-2010年8月对56例先天性耳前瘘管的患者在感染期行手术治疗,效果满意,现报道如下.     

经皮扩张气管切开术在耳鼻咽喉科的临床应用

目的 探讨经皮扩张气管切开术在耳鼻咽喉科的临床应用.方法 本科自2007年以来共完成经皮扩张气管切开术25例,与传统气管切开术30例在手术时间、术中出血量、手术切口长度及手术费进行比较.结果 经皮扩张气管切开术较传统气管切开术具有手术时间短、术中出血量少、手术切口美观的优点,但费用昂贵.结论 经皮扩张气管切开术具有快速、微创的优点,在临床耳鼻咽喉科的急救中值得推广和掌握.