硫酸二甲酯眼损伤的临床表现及治疗

对我们所遇８例硫酸二甲酯眼部中毒的临床表现及治疗进行分析讨论。眼部中毒主要为酸性烧伤、角膜损害,常同时合并呼吸道症状,重者可合并肝肾损害。治疗以硷性溶液冲洗结膜囊及局部对症为主。     

Metabolism of liriodendrin and syringin by human intestinal bacteria and their relation toin vitro cytotoxicity

When liriodendrin or syringin was incubated for 24 h with human intestinal bacteria, two metabolites, (+)-syringaresinol-beta-D-glucopyranoside and (+)-syringaresinol, from liriodendrin and one metabolite, synapyl alcohol, from syringin were produced. The metabolic time course of liriodendrin was as follows: at early time, liriodendrin was converted to (+)-syringaresinol-beta-D-glucopyranoside, and then (+)-syringaresinol. The in vitro cytotoxicities of these metabolites, (+)-syringaresinol and synapyl alcohol, were superior to those of liriodendrin and syringin.     

The effect of polycythemic hyperviscosity on ischemic bowel necrosis

It is known that polycythemia decreases the fluidity of the blood and impairs tissue perfusion due to red-cell sludging in the microcirculation. In this study, the effect of polycythemic hyperviscosity (PH) on bowel necrosis was evaluated in an experimental model of intestinal ischemia. Twenty-eight Wistar albino rats (90–170 g) were divided into two groups: group 1 was transfused to create hyperviscosity and then intestinal ischemia was produced (n = 16); in group 2 ischemia was produced without transfusion (n = 12). Intestinal ischemia was produced by clamping the superior mesenteric artery and the collateral arcades of the right colic artery for 30 min. Gross and histopathologic evaluations were performed by either immediate necropsy or relaparotomy 24 h later. Microscopic findings were graded from 0 to 3 according to the degree of ischemic changes. In group 1, 2 animals (12.5%) died before 24 h postoperatively; coagulation necrosis with grade 2 or 3 ischemic changes was observed in 10 animals (62.5%). In group 2 only a few hypertrophied Peyer's patches and capillary dilation were found, and all histopathologic changes were between grades 0 and 1. The difference between the histopathologic gradings of the two groups was significant (P < 0.001). It appears that in addition to reduced splanchnic blood flow, a secondary effect of PH is needed to induce ischemic coagulation necrosis. PH of the newborn must be considered a risk factor for necrotizing enterocolitis, so-called spontaneous intestinal perforations, and even intestinal atresia.Presented at the 1st European Congress of Pediatric Surgery, Graz/Austria, May 4–6, 1995     

Acquired hyperoxaluria and haematuria in children

Two children with extensive ileal resection are reported. They developed gross haematuria of non-glomerular origin, without stones or nephrocalcinosis. Previous reports indicate that acquired hyperoxaluria is common in children with a variety of intestinal disorders. Our patients had hyperoxaluria. We think that hyperoxaluria may be the cause of haematuria through a pathogenetic mechanism similar to the one ascribed to haematuria secondary to hypercalciuria and hyperuricosuria.     

The effect of naringenin on the intestinal and renal transport of organic solutes

Summary Naringenin (4,5,7-trihydroxy-flavanone) inhibits the accumulation of glycine, -methyl-glucoside, p-amino-hippurate and N¹-methyl-nicotinamide in dog renal cortex slices. It also inhibits oxygen consumption by this tissue. Since the sensitivity of amino-acid uptake to the drug is less than the sensitivity of oxygen consumption, the inhibition of this transport might be secondary to an effect on intermediary metabolism. The inhibition of PAH uptake occurs at a lower concentration of the drug, and so naringenin may affect this process at the membrane level.Naringenin inhibits the transport of sugars and amino-acids by dog, guinea-pig and rat small intestine. Both steady-state accumulation and initial rates of entry are affected. Amino-acid uptake is depressed both in the presence or absence of sodium ions. The inhibition is reversible provided short contact times are employed. According to kinetic analysis, naringenin appeared to be a fully non-competitive inhibitor of phenylalanine influx. Examination of the unidirectional transmural fluxes of phenylalanine across guinea-pig intestine revealed that only the mucosal-serosal flux was affected, and then only if the flavanone was added to the solution bathing the mucosal face of the tissue. Naringenin does not inhibit mucosal Na⁺-K⁺-ATPase, but it does alter the intracellular ion concentrations.Although some of the results can be explained in terms of an effect of naringenin on metabolism, others can not. It is argued that naringenin has a direct action on cell membranes.Some of these results have been presented to the Physiological Society and a short report has appeared in their proceedings (Robinson, 1979)     

补肾益骨膏对大鼠肝肾的损害作用

目的:观察连续给予补肾益骨膏对大鼠肝、肾的损害作用及其损害的可逆性.方法:将144只大鼠分成对照组,补肾益骨膏高、低剂量组,各组动物按1.5 mL&#8226;kg 1等体积分别灌胃,高、低剂量组分别按60.0,15.0 g&#8226;kg 1给予补肾益骨膏,对照组给予等体积的纯化水,每天连续灌服给药,周日休息,共180 d;用药90,180 d及停药30 d,分3批处死动物,采血进行与肝、肾功能相关的血清生化检测及其病理组织学检查.结果:补肾益骨膏长期给药对肾脏有可疑损害作用,对肝脏有轻度可逆性损害作用.结论:临床长期大剂量使用补肾益骨膏应注意肝、肾功能的检查.     

巢蛋白(Nestin)在胃肠道间质瘤组织中的表达及其临床意义

目的　通过检测胃肠道间质瘤 (GIST )组织中巢蛋白 (nestin)的表达 ,探讨nestin在GIST的诊断、鉴别诊断及起源中的意义。方法　应用免疫组织化学技术EnVision微波二步法 ,检测 94例GIST (良性 44例 ,恶性 5 0例 )组织中nestin蛋白的表达 ,并与平滑肌瘤和平滑肌肉瘤进行对照研究。结果　GIST组织中nestin的阳性表达率为 95 .7% ( 90 /94) ,良、恶性组nestin的阳性率分别为 97.7% ( 4 3 /4 4)、94.0 % ( 4 7/5 0 )。 2组的表达水平无显著性差异 (P >0 .0 5 )。平滑肌瘤和平滑肌肉瘤nestin表达均阴性。结论　Nestin作为胃肠道间质瘤的 1种特异而敏感的新标志物 ,对GIST的诊断及鉴别诊断有重要意义 ,但不能作为GIST分化程度的指标 ,同时提示GIST可能起源于向卡哈尔细胞 (ICC )表型分化的干细胞。     

Pyloroduodenal duplication cyst: case report

A 6-day-old female presented with vomiting and an abdominal mass. At laparotomy, a pyloroduodenal duplication cyst was enucleated from the pyloric region. Of the diagnostic studies performed, IV cholangiography with spiral computed tomography and an upper gastrointestinal barium study were useful in the preoperative differential diagnosis.     

Clinical impact of intestinal neuronal malformations: a prospective study in 141 patients

A prospective study of 141 consecutive patients with intestinal neuronal malformations is presented. The single malformation of the autonomic nervous system that always required surgical intervention was aganglionosis. Giant ganglia, reduced parasympathetic tone, immature ganglia, and hypogenetic or heterotopic nerve cells were seen in all forms of malformations. However, the incidence in specific malformations was variable. Multiple giant ganglia were identified in all patients with intestinal neuronal dysplasia (IND) type B, but also in various other malformations. Heterotopic nerve cells in the myenteric plexus were seen in the proximal segment of 15 of 74 patients (20.3%) with aganglionosis and 5 of 9 patients (55.6%) with hypoganglionosis. A significant impact on symptoms was found for IND type B: 34 (45.9%) of 74 children with aganglionosis had associated IND type B, and these children more frequently developed ileus (P < 0.001) and more often needed a second resection (P < 0.05) compared to those with isolated aganglionosis. This indicates an additive effect of both malformations, and therefore, in these patients an extended resection should be carried out.Twelve of 67 patients (17.9%) without aganglionosis needed resection for untreatable constipation. This included 7 of 9 children with hypoganglionosis, both patients with heterotopia of the myenteric plexus, 1 of 20 with isolated IND type B, and 2 of 12 with reduced parasympathetic tone. None of the patients with immaturity, heterotopia of the submucous plexus, or mild dysganglionosis required surgery. Six children (8.9%) without aganglionosis underwent sphincteromyotomy and 2 with IND type B had a temporary colostomy. At follow-up (mean 2.4 ± 1.4 years), the outcome in patients with resected aganglionosis was better than in patients who had resections for other malformations; 49 (69%) of 71 patients with aganglionosis were asymptomatic compared to 4 (33.3%) of 12 with other malformations (P < 0.05). It is concluded that some intestinal malformations have a relevant clinical impact. However, the severity of symptoms in the individual patient may not be explained by specific histochemical findings from a limited number of mucosal biopsies. The pathognomonic histochemical criteria of isolated IND typeB — immaturity, reduced parasympathetic tone, heterotopia of the submucous plexus, and mild dysganglionosis —rarely require surgical therapy and should be treated conservatively.     

结直肠癌伴穿孔的诊治体会

目的：探讨有效地预防结、直肠癌伴穿孔的发生及合理治疗结、直肠癌伴穿孔的方法。方法：用X2检验分析742例患者的5年生存率与其中的11例伴穿孔患者的5年生存率（所有病例均随访5年以上）。结果：全部742例结、直肠癌患者的5年生存率为58.6％。11例伴穿孔患者的5年生存率仅为18.2％。4例伴急性穿孔患者中的3例有诱发穿孔的因素。穿孔的部位大多发生在左侧结肠；其病理类型多数为粘液腺癌。结论:结、直肠癌伴穿孔患者的预后很差，在诊治过程中避免医源性的诱发穿孔因素值得重视；特别是结、直肠癌伴不全性梗阻时，要慎重选择检查手段及清洁肠道准备的方法。