改良Ⅱ期法耳廓再造术

目的 探讨改良Ⅱ期法耳廓再造的方法并总结6年来的临床应用经验。方法 对146例（155耳）小耳畸形患者行耳廓再造术,手术分Ⅱ期进行。Ⅰ期：采用“U”形切口,切除残耳,在耳后分离合适的腔隙,置入肋软骨耳支架,耳垂向后转位衔接于再造的耳廓下方。6个月后行Ⅱ期手术：掀起耳廓,耳后置入软骨块,颞浅筋膜瓣转移覆盖后行中厚皮片移植术。结果 146例患者中141例（150耳）Ⅰ期术后恢复顺利,伤口愈合良好;5例（5耳）Ⅰ期术后4～6d出现皮瓣尖端坏死,范围约1.0 cm×1.5 cm,经换药后痊愈,未出现软骨外露、感染等;139例（147耳）Ⅱ期术后耳后移植皮片成活良好,7例（8耳）Ⅱ期术后出现耳后移植皮片部分成活不良,换药1周后愈合。146例患者随访94例（97耳）,失访52例（58耳）,随访时间为术后6个月至2年,随访病例均无感染、软骨吸收等并发症,再造耳廓结构清晰,耳颅角稳定。结论 改良Ⅱ期法耳廓再造手术操作相对简单,易于掌握,是耳廓再造的较为理想的方法之一。     

鼻NK/T细胞淋巴瘤的临床及病理学特征分析

目的探讨鼻NK/T细胞淋巴瘤的临床及组织病理学特征。方法对经治的21例鼻腔NK/T细胞淋巴瘤患者临床资料进行回顾性分析，总结其临床特点及组织病理学特征。结果患者主要临床症状表现为单侧鼻塞及脓血涕；经鼻内镜检查，证实肿瘤位于鼻腔外侧壁者17例，位于鼻中隔者4例；肿瘤形状类似于息肉样病变者9例，肿瘤表面糜烂且质脆者12例；CT显示肿瘤居于鼻腔前部者17例，发于鼻中隔者4例；病变累及上颌窦者12例，累及筛窦3例，同时累及上颌窦与筛窦者6例。病理学检查显示鼻型NK/T细胞淋巴瘤15例，外周T细胞淋巴瘤6例。结论本病临床表现缺乏特异性，CT检查有利于确定病变范围及临床分期，多部位活检及免疫组织化学检查是确诊鼻NK/T细胞淋巴瘤的主要依据。     

Café-au-lait macules and pediatric malignancy caused by biallelic mutations in the DNA mismatch repair (MMR) gene PMS2

A 14-year-old male presented with a T4 sigmoid adenocarcinoma, <10 colonic adenomas and multiple café-au-lait macules. Family history was not suggestive of a dominant hereditary form of colorectal cancer. Evaluation of the tumor revealed abnormal immunohistochemical staining of the PMS2 protein and high frequency microsatellite instability. Germline analysis identified biallelic PMS2 missense mutations. A new cancer syndrome caused by biallelic mutations in the mismatch repair genes, including PMS2, is now emerging and is characterized by café-au-lait macules, colonic polyps and a distinctive tumor spectrum.     

A dose-finding study of glycosylated G-CSF (Lenograstim) combined with CHOP therapy for stem cell mobilization in patients with non-Hodgkin's lymphoma

BACKGROUND: Peripheral blood stem cell (PBSC) reinfusion has been widely used for hematopoietic reconstitution after high-dose chemotherapy. However, the optimal dose of granulocyte colony-stimulating factor (G-CSF) for PBSC mobilization in combination with chemotherapy for autograft remains unknown. METHODS: To find the optimal dose of glycosylated G-CSF (lenograstim) for PBSC mobilization in combination with chemotherapy for aggressive non-Hodgkin's lymphoma (NHL), we conducted a dose-finding study on 43 newly diagnosed patients who had unfavorable prognostic factors. They received four to six courses of cyclophosphamide, doxorubicin, vincristine and prednisolone combined with lenograstim every 2 weeks (biweekly CHOP therapy). PBSC apheresis was started after the third course of biweekly CHOP therapy. Lenograstim was given daily from day 3 until the day of the last apheresis. The optimum dose of lenograstim was assessed based on mobilization efficacy and safety profiles at a daily single dose of 2, 5 and 10 microg/kg for eight patients in each level. RESULTS: The collected number of CD34+ cells in the first apheresis products was higher in the 5 microg/kg group than in the 2 microg/kg group (median, 4.22 x 10(6) vs 2.49 x 10(6) CD34+ cells/kg, P = 0.051). The highest dose of 10 microg/kg (median, 2.99 x 10(6) CD34+ cells/kg) failed to show a dose dependence in PBSC mobilization. The efficacy and safety of the 5 microg/kg dose were further confirmed in an additional 19 patients. CONCLUSIONS: The present study suggests that the recommended dose of lenograstim for PBSC mobilization with CHOP therapy in untreated NHL is 5 microg/kg.     

Phthalides from Pittosporum illicioides var. illicioides with inhibitory activity on superoxide generation and elastase release by neutrophils

Six new phthalides, (S)-3-ethyl-7-hydroxy-6-methoxyphthalide (1), (S)-3-ethyl-7-hydroxy-5,6-dimethoxyphthalide (2), (S)-3-ethyl-5,6,7-trimethoxyphthalide (3), (R)-3-ethyl-7-hydroxy-6-methoxyphthalide (4), (Z)-3-ethylidene-7-hydroxy-6-methoxyphthalide (5), and (Z)-3-ethylidene-6,7-dimethoxyphthalide (6), have been isolated from the root of Pittosporum illicioides var. illicioides, together with seven known compounds. The structures of these new compounds were determined through spectroscopic and MS analyses. Compounds 1-4 exhibited inhibition (IC50相似文献   

Cucurbitane-type triterpenoids from the stems of momordica charantia

Four new cucurbitane-type triterpenes, cucurbita-5,23(E)-diene-3beta,7beta,25-triol (1), 3beta-acetoxy-7beta-methoxycucurbita-5,23(E)-dien-25-ol (2), cucurbita-5(10),6,23(E)-triene-3beta,25-diol (5), and cucurbita-5,24-diene-3,7,23-trione (6), together with four known triterpenes, 3beta,25-dihydroxy-7beta-methoxycucurbita-5,23(E)-diene (3), 3beta-hydroxy-7beta,25-dimethoxycucurbita-5,23(E)-diene (4), 3beta,7beta,25-trihydroxycucurbita-5,23(E)-dien-19-al (7), and 25-methoxy-3beta,7beta-dihydroxycucurbita-5,23(E)-dien-19-al (8), were isolated from the methyl alcohol extract of the stems of Momordica charantia. The structures of the new compounds were elucidated by spectroscopic methods.     

Lung collapse induced by pulmonary hemorrhage: a rare complication of hysteroscopy

Pulmonary hemorrhage is a rare but sometimes fatal complication of hysteroscopy. We present the first case report in which a healthy patient developed lung collapse induced by pulmonary hemorrhage after operative hysteroscopy. The possible etiologies of this rare complication are also discussed.