Les nouvelles techniques diagnostiques des tumeurs neuroendocrines pancréatiques*<br/>The New Diagnostic Techniques for Pancreatic Neuroendrocine Tumours

Pancreatic neuroendocrine tumours are the tumours developed at the expense of pancreas and require a specific diagnostic assessment. The imaging assessment of a pancreatic neuroendocrine tumour is useful for diagnosis as well as for surgical/medical treatment. Recently, a number of advances have been made in the field of imaging pancreatic neuroendocrine tumours, in particular in functional imaging using radiolabelled somatostatin analogues. In this review, we approach diagnostic progress by focusing on the advances of recent years. Thus, the interest of conventional imaging (scanner, abdominal ultrasound, and magnetic resonance imaging), ultrasound endoscopy and the place of functional imaging mainly with radiolabelled somatostatin analogues are discussed.

Résumé
Les tumeurs neuroendocrines pancréatiques (TNEp) sont des tumeurs développées aux dépens du pancréas et nécessitent un bilan diagnostique spécifique. Le bilan d’imagerie d’une TNEp est utile pour le diagnostic ainsi que pour le traitement chirurgical/médical. Récemment, un certain nombre de progrès ont été réalisés dans le domaine de l’imagerie des TNEp, en particulier en ce qui concerne l’imagerie fonctionnelle utilisant des analogues de la somatostatine radiomarqués. Dans cette mise au point, nous abordons les progrès diagnostiques en nous focalisant sur les avancées des derniè- res années. Ainsi, il est abordé l’intérêt de l’imagerie conventionnelle (scanner, échographie abdominale, imagerie par résonance magnétique), de l’échoendoscopie et la place de l’imagerie fonctionnelle, principalement avec des analogues de la somatostatine radiomarqués.     

合谷穴与面口部特异性联系的脑网络功能研究

Objective:This study was designed to observe the effect of electroacupuncture at Hégǔ(合谷L14),or Hòuxī(后溪SI3) or Wàiguān(外关TE5) acupoints on the function of the brain regions of a healthy human,and to explore the neural information mechanism of a specific connection between LI4 and the facialoral area from the point of view of the brain function connection network.A further objective was to enrich knowledge of the specific connection between the body surface and the meridian route,and the specificity of acupoint effects.Methods:A total of 30 healthy volunteers were randomly assigned to LI4,SI3,and TE5 groups.The members of each group were stimulated with electroacupuncture,and their heads were scanned using fMRI.DPARSFA 2.4 and REST 1.8 software were used for data preprocessing and statistical analysis.The paired t-test was used within group and the double sample t-test was used for two-group comparisons.Results:In healthy people,left LI4 with electroacupuncture mainly caused a decrease of the functional connection of the right orofacial motor area of the brain,which remained decreased after removing the needle.When LI4 was compared with SI3 and TE5,LI4 caused a more significant decline in the functional connection of the right side of the brain during acupuncture.Conclusions:Acupuncture at LI4 has a significant effect on the function of the face-and mouth-related areas in the brain,and there is a continuous effect.It is suggested that LI4 and the face and mouth have a specific relationship in the brain,which is most obvious during acupuncture.     

血浆置换在神经系统疾病中的应用

目的回顾分析血浆置换（plasma exchange,PE）治疗神经免疫性疾病患者的资料,了解其疗效和不良反应。方法对78 例应用PE 换治疗过的患者资料回顾性分析,其中包括73 例重症肌无力（myasthenia gravis,MG）,3 例吉兰巴雷综合征（Guillain-Barre′syndrome,GBS）,1例慢性炎性脱髓鞘性多神经根神经病（chronic inflammatory demyelinating polyneuropathy, CIDP）和1 例多发性硬化（multiple sclerosis,MS）。PE 头3 次为隔日1 次,之后为隔周1 次,偶有1周2 次。应用临床评分观察疗效,根据临床记录了解有关副反应。结果 73 例MG 患者PE 后第3d、第14d和第30d临床绝对评分明显降低,差异具有统计学意义。PE对3例GBS和1例CIDP患者疗效肯定,1例MS患者行双重置换（double filtration plasmapheresis,therapy, DFPP）后临床症状改善不明显,以上患者在PE 治疗过程中未见严重不良反应。结论 PE 在多数神经系统免疫疾病如MG、GBS 和CIDP 疗效肯定,不良反应较少。在治疗中枢神经系统脱髓鞘病（例如MS等）的情况有待进一步观察。     

影响内淋巴囊减压术后生活质量的相关因素分析

目的研究内淋巴囊减压术治疗梅尼埃病的临床效果;通过患者术后生活质量评分分析手术适应症及影响手术效果的相关因素。方法病例材料来源于北京大学人民医院耳鼻咽喉科1996年至2011年收治的梅尼埃病病例共71例,选择反复发作眩晕且有实用听力者进行内淋巴囊减压术,术前完善检查并根据听力分期、听力曲线、病程、随访期限等进行分组,术后进行随访,生活质量的评测采用梅尼埃病内淋巴囊减压术生活质量调查问卷MDOQ。结果内淋巴囊减压术后生活质量相应改善的梅尼埃患者为87.69%,3.08%不变,9.23%变差。QOL的得分与年龄、性别、随访时间、病程等无明显统计学相关,与术前听力分期、术前听力学曲线类型有统计学意义。结论内淋巴囊减压术能有效改善梅尼埃病患者的术后生活质量。术前不同分期与内淋巴囊减压术后疗效有明显统计学差异,分期为2、3期的患者疗效要好于4期患者,听力曲线为上升型的效果优于其他类型。     

Sézary syndrome: a rare form of cutaneous T-cell lymphoma

Sézary syndrome (SS) is an erythrodermic, aggressive,cutaneous T-cell lymphoma (CTCL) characterized by a malignant T-cell clone that localizes in the blood and skin, and its diagnosis is based on clinical, histological and biological features. Here we describe a typical case of SS.     

New insights into the effects of Mycobacterium bovis Bacillus Calmette-Guérin on asthma

Allergic asthma has been defined as a disease of immunodysregulation, where the pathology is a direct consequence of excessive T-helper type 2 immune responses （Th2） to allergens in the lungs. Disease is associated with increased secretion of type-2 cytokines such as interleukin （IL）-4, IL-5 and IL-13 which, among other things,     

NF1基因突变致1型神经纤维瘤病8例临床分析

目的了解1型神经纤维瘤病(NF)的临床表型特征及异质性。方法回顾分析8例NF患儿的临床及基因检测资料。结果 8例患儿中男5例、女3例,均因生后多发牛奶咖啡斑就诊,2例伴丛状神经纤维瘤,1例伴多处皮肤神经纤维瘤。8例患儿有7种突变形式,NF1基因全部缺失2例;4种缺失突变,分别为c.4974_4977delCTAT,p.Y1659TfsX17、c.3987_3988delAG,p.S1329fsX4、c.1511delC,p.P504QfsX22和c.6388delC,p.L2130fsX3;1种c.3975-2delA剪切突变;1种c.3721 CT,p.R1241X无义突变。除全基因大片段缺失和无义突变之外,其余均为未报道的新突变。患儿父母外周血均未检测出相应的突变。结论 NF1基因突变可致1型NF,此研究发现5种新的突变,且均为de novo突变。多发牛奶咖啡斑是1型NF最早的临床表现,对疑似患者应尽早行基因分析确诊。     

抗结核重组BCG疫苗研究进展

结核病仍是严重威胁人类健康的传染病之一,卡介苗(mycobacterium bovis bacillus calmette-guérin,BCG)是唯一被批准用于结核病预防的疫苗,但近年来的研究发现其免疫保护效果极不稳定,构建重组BCG成为目前新型抗结核疫苗研究的重要方向之一。本文概括性地介绍了抗结核重组BCG疫苗研究的必要性、抗结核重组BCG的研究策略与研究进展以及存在的问题和未来展望。     

康-克二氏综合征3例报告

分析3例康－克二氏综合征患者的临床表现，发现其主要临床表现以联想性精神自动症、躯体感觉性精神自动症和运动性精神自动症为主要特征。同时对该病预后进行了探讨，为临床诊断治疗及预后评估提供参考依据。