Benign schwannoma of the pancreas

Reported cases of intrapancreatic schwannomas have recently increased in the literature. However, none of these cases were diagnosed clearly as schwannoma preoperatively. We herein describe the clinicopathologic findings of a solitary benign schwannoma occurring in the head of the pancreas. Additionally, the differential diagnosis versus other cystic- and solid-appearing pancreatic masses is briefly discussed.     

钠钙交换器抑制药在心律失常治疗中的应用

心肌钠钙交换在调节心肌细胞内外钠、钙平衡中发挥重要作用。钠钙交换分为前向型和逆向型2种。在心力衰竭、心肌缺血、心肌再灌注等病理情况下,通过钠钙交换器的离子交换可产生致心律失常性的一过性内向电子流,引起延迟后除极和非折返激动型的室性心动过速。钠钙交换器抑制药在预防这些病理情况下的心律失常具有潜在的作用。     

小鼠吗啡依赖纳洛酮催促戒断跳跃反应模型的建立

目的建立稳定的小鼠吗啡依赖纳洛酮催促戒断跳跃反应模型。方法小鼠连续皮下注射吗啡,以纳洛酮催促戒断跳跃反应为指标,调整吗啡给予天数(5,6,7,10d)、吗啡累积剂量(360,560,640,945,1100,1105,1200mg/kg)、每日给予吗啡的频数[一天二次(bid),一天三次(tid)]、纳洛酮催促紧前给予吗啡与否、以及纳洛酮剂量(10,20mg/kg),建立四个造模方案包括八个子方案。结果方案A、B2、C2吗啡组小鼠跳跃反应率未达100%;方案B1、C1、D2、D3、D4吗啡组小鼠跳跃次数变异系数较大。方案D1采用小鼠连续皮下注射倍增剂量的吗啡,tid×6d,每日每次剂量分别为5,10,20,40,80,160mg/kg;第7天皮下注射吗啡160mg/kg,3h后腹腔注射纳洛酮10mg/kg,吗啡组小鼠可产生显著的跳跃反应,与对照组比较差异有显著性(P<0.01),且变异系数小(CV为0.22),该方案吗啡依赖小鼠跳跃反应次数适度,离散度小。结论选用方案D1可建立稳定的小鼠戒断跳跃反应模型。     

性别差异对脓毒症大鼠肝脏Toll样受体4和髓样分化蛋白-2基因表达的影响

目的探讨性别差异对脓毒症大鼠肝脏组织Toll样受体4(TLR4)和髓样分化蛋白- 2(MD-2)基因表达的影响。方法以脂多糖(LPS)按5 mg/kg体重由大鼠腹腔注射制作脓毒症动物模型,注射后2 h留取肝脏组织检测TLR4、MD-2和肿瘤坏死因子-α(TNF-α)基因表达,同时测定各组大鼠血浆中丙氨酸氨基转移酶(ALT)及雌二醇含量。结果正常雌雄性大鼠肝脏组织均可表达少量TLR4、MD-2、TNF-α基因,其中雌性组分别为0．175±0．034、0．211±0．044、0．201±0．068; 雄性组分别为0．205±0．061、0．243±0．049、0．243±0．063,两组数据差异无统计学意义(P> 0．05),但LPS刺激后雌性大鼠肝脏组织上述指标分别为0．615±0．089、0．708±0．181、0．730± 0．118,血浆中ALT含量为(81．07±10．72)U／L;雄性组分别为0．723±0．091、1．123±0．272、 0．881±0．156,ALT含量为(106．39±14．21)U／L,雌性组各项指标均明显低于雄性大鼠(P< 0．05)。相关分析表明雌性及雄性脓毒症大鼠肝脏组织TLR4及TNF-α基因表达与相应性别大鼠血浆中雌二醇含量呈显著负相关(P<0．05)。结论 LPS刺激后大鼠肝脏组织TLR4、MD-2及 TNF-α基因表达存在性别差异,内源性雌激素的作用可能导致雌性脓毒症大鼠肝脏组织损伤较雄性轻。     

Crohn病的CT表现

目的探讨Crohn病的CT表现特点。方法回顾性分析经病理证实的18例Crohn病的CT征象，大多数病例采用螺旋CT或多层螺旋CT扫描。结果所有病例均有节段性肠壁增厚，CT增强有7例表现为肠壁均匀增厚，缺乏层次，同时肠壁强化不明显；有11例表现为黏膜增厚和分层形成“靶征”和“双环征”，肠壁厚度多在5～10mm；有9例表现为病变段肠管周围纤维脂肪成分增多，蜂窝织炎及肠周或肠系膜血管增多增粗。有5例CT首先考虑为其他疾病，1例考虑为闭攀性肠梗阻，1例首先考虑为肠结核，2例回盲部病变怀疑为癌，1例肠穿孔形成脓肿仅诊为化脓性感染。结论cT不但能准确显示Crohn病肠壁、肠系膜及周围结构的异常，增强CT还能区分活动性与非活动性病变，有助于临床采取合理而积极的治疗方案。     

Comparison of trichloroethylene and enflurane as adjuncts to nitrous oxide and relaxant anaesthesia

Forty women who underwent gynaecological surgery were randomly allocated to receive trichloroethylene, enflurane, or enflurane plus fentanyl as adjuncts to nitrous oxide/relaxant anaesthesia with controlled ventilation. No serious cardiac dysrhythmias were seen in any group. Each patient was observed postoperatively for 4 hours by a nurse blind to the technique used, and questioned at 24 hours by a similarly blinded anaesthetist. Recovery after trichloroethylene was not significantly prolonged although postoperative analgesia by visual analogue was better, opiate analgesia was required less frequently and there was less nausea and vomiting than in either of the enflurane groups. We argue for the continued use of trichloroethylene by this technique, because it costs one hundred times less than enflurane and because of the potential morbidity of the postoperative opiate dosage required after enflurane.     

间接免疫荧光法检测婴幼儿急性下呼吸道合胞病毒感染的特异性IgM

本文对1984年1～3月和1985年3～8月共107例急性下呼吸道感染的住院患儿,采用间接免疫荧光法检测其急性期血清抗RSV特异性IgM抗体,并与病毒分离和/或中和试验比较,敏感性为82.1％,特异性为71.8％。RSV感染患儿发病后3天内大多数病例即可从血清中检测出RSV-IgM,因此该法具有早期诊断价值。     

D1期前列腺癌的诊断

１９９０年１２月至１９９３年１２月，我们对临床Ａ－Ｃ期２７例病人进行盆腔淋巴结活检术，检出１２例Ｄ１期病人。临床Ａ期有５０％，Ｂ期有３７％，Ｃ期有７１％的病人发现盆腔淋巴结癌转移，其癌细胞的恶性程度也与淋巴结癌转移有关。近年，经腹腔镜盆腔淋巴结活检已成为诊断Ｄ１期前列腺癌的新方法。     

Spinal anaesthesia in a child with Job''s syndrome, pneumatoceles and empyema

We present a case of acute bowel obstruction in an immunocompromised child, who also had lobar pneumonia and a giant unilateral pneumatocele. She was successfully managed with subarachnoid anaesthesia for exploratory laparotomy to relieve a colonic obstruction. This proved to be a safe alternative to general anaesthesia with tracheal intubation in this patient and should be considered in infants and children in selected cases whenever a contraindication to general anaesthesia exists.     

Acute viral myocarditis A death associated with anaesthesia

The death of a 35-year-old woman in the immediate postoperative period as a result of undiagnosed acute viral myocarditis is described. The presentation, diagnosis and course of the disease is discussed. It is recommended that wider use to be made of routine electrocardiographs as a screening test.