Sarcoidosis presenting with prolonged fever in a patient with sickle cell anemia.

Although the leading causes of fever and pulmonary infiltrates in sickle cell patients are acute bacterial pneumonia and the acute chest syndrome, the former is usually responsive to antibiotics and not protracted, and the clinical course of the latter is short and self-limited. A patient with sickle cell anemia presented with fever and pulmonary infiltrates of several weeks duration that were unresponsive to antibiotics. Gross endobronchial abnormalities were noted on bronchoscopy, and the biopsies were consistent with sarcoidosis. The diagnosis of sarcoidosis can be difficult to establish in a patient with sickle cell anemia and protracted fever since both disorders are associated with chronic interstitial changes on the chest radiograph as well as restrictive physiology.     

平板运动试验Q-Tc、Q-Tr和△Q-Tc对冠心病的诊断价值:与冠脉造影结果对照

78例病人接受冠脉造影和次极量平板运动试验,探讨Q-Tc、Q-Tr和△Q-Tc预测冠脉病变的准确性。Q-Tc与Q-Tr的敏感度,特异度,阳性预测值及诊断准确率分别为84,76,83,81％与69,88,89,77％,与ST段降低的相比无明显差别,提示其诊断价值相似。与心血管造影资料对照,上述指标能反映冠脉病变的程度。△Q-Tc的敏感度低(58％)而特异性高(94％),其诊断准确性(73％)与其他指标相比无显著差异,故有应用价值。     

贫血患者血清红细胞生成素浓度的测定及临床意义

用小鼠胎肝细胞体外血浆凝块培养红系集落(Erythroid colong formig unit inculturc,E-CFUc)方法,以红细胞生成素(Erythropoietin,EPO)850323为标准试剂,测定正常人、贫血病人血清EPO浓度。实验用妊娠13～15d小鼠胎肝细胞。血清均经透析处理,培养液中加量最大不超过10％。EPO(850323)在培养液中浓度为2.5～100mU/ml。血清EPO(mU/ml)测定结果:28例正常人为48.O±17.7,12例再生障碍性贫血病人为946～>10000,1例巨幼细胞性贫血病人为500,1例缺铁性贫血病人为400和18例慢性肾功能衰竭病人则为94.2±87.6。结果表明:贫血病因对血清EPO浓度有影响。     

Heat probe thermocoagulation as a substitute for surgical intervention to arrest massive peptic ulcer hemorrhage: an experience in 153 cases

In a period of 2 years 7 months, we performed heat probe (HP) thermocoagulation in 153 cases of massive peptic ulcer hemorrhage. The male/female sex ratio was 125/28. The average age was 57.6 +/- 1.3 years (mean +/- SEM; range, 17 to 88). There were 69 cases (45.1%) of spurting hemorrhage, 50 cases (32.7%) of oozing hemorrhage, and 34 cases (22.2%) of nonbleeding visible vessels. Seventy-seven patients (50.3%) were in shock before therapy. After therapy we obtained initial success in 147 cases (96.1%). Rebleeding episodes occurred in 23 patients (15.6%) within 1 month after therapy. Nineteen patients received a second therapy, and treatment in 15 of these cases (78.9%) was ultimately successful. Finally, treatment in 142 cases (92.8%) was ultimately successful. The duration of hospitalization was 6.3 +/- 0.4 days (mean +/- SEM). After discharge all patients were followed at the outpatient department for at least 1 month. Sixty-seven patients were followed endoscopically for at least 2 to 3 months after therapy. Fifty-six patients (83.6%) had a healed scar at the previous bleeding site 2 months after therapy, and 62 patients (92.5%) had a healed scar 3 months after therapy. We conclude that HP thermocoagulation is an ideal and reliable modality of therapeutic endoscopy in arrest of massive peptic ulcer hemorrhage. HP thermocoagulation may become the first choice of therapy for massive peptic ulcer bleeding in the near future.     

Laparoscopic appendicectomy — A successful operation in adults and children

Laparoscopic appendicectomy has been the subject of several encouraging reports, but has not as yet gained widespread acceptance. We present a series of 159 consecutive laparoscopic appendicectomies performed, over a 4 yr period, in both adults and children. We find the procedure as safe as its open counterpart, with patients fit to leave hospital within the same time period. Perforated appendices were amenable to this procedure, and the location of the appendix did not alter the outcome. Children responded as well as adults post-operatively. Obesity may be an indication for this form of treatment. Removal of displaced faecoliths associated with perforated appendicitis is a difficult technical problem in less than 5 per cent of patients.     

中老年人前列腺体积增长的城乡差异

为了解国人中年以后前列腺的生长情况及其可能的影响因素，对北京、河北、湖北等地四个社区的城乡居民前列腺体积进行了经腹Ｂ超测量。结果表明城区居民的前列腺体积明显大于相应年龄段的农村居民，城区居民的前列腺增长速率比农村居民高二倍。生活环境和饮食习惯的不同可能为其原因之一。     

鱼油抗大鼠实验性心律失常作用

鱼油口服给药1.4 ml/kg·d,连续15d能显著升高氯化钡致大鼠心律失常的阈剂量(P<0.05),降低心律失常的严重程度(P<0.05),60 min内窦性心率恢复率为85.7％(P<0.01),死亡率为0。心肌细胞膜脂肪酸分析显示,鱼油影响大鼠心肌细胞膜脂肪酸组成,升高DHA含量(P<0.05),降低AA含量及AA/DHA比值(P<0.01)。多元逐步回归分析表明,鱼油的抗心律失常作用与其升高心肌细胞膜DHA含量有关,相关系数为r=-0.5872(P<0.01)。     

Occurrence of the t(2;5)(p23;q35) in non-Hodgkin's lymphoma

Primary CD30(Ki-1)-positive anaplastic large-cell lymphoma (ALCL) is considered by some to be a distinct clinicopathologic entity associated with the t(2;5) (p23;q35). However, the specificity of t(2;5) for ALCL has not been carefully studied. Therefore, we performed a detailed analysis of all cases of ALCL with abnormal cytogenetics results in the Nebraska Lymphoma Study Group registry, as well as all other cases of non-Hodgkin's lymphoma with t(2;5) in the registry. We found the t(2;5) in only five of 10 cases of ALCL, four of whom were young patients. However, we also found the t(2;5) in 11 other cases of nonanaplastic lymphoma, including eight children with typical peripheral T-cell lymphomas of various types. The t(2;5) was also found in three older adults with B-cell lymphomas of various types. Thus, the t(2;5) was not specific for CD30+ ALCL. However, t(2;5) may define a clinicopathologic entity in children and young adults characterized by variable morphologies with a T-cell or indeterminate phenotype, CD30-positivity, nodal disease with frequent extranodal involvement, advanced stage, and an excellent response to therapy, including bone marrow transplantation for relapsed disease. The clinical relevance of the t(2;5) in older patients requires further study.