瑞芬太尼用于小儿气管异物镜检术麻醉的临床研究

目的研究瑞芬太尼用于小儿支气管异物镜检术麻醉对应激反应的影响。方法气管异物患儿30例,随机分为两组,A组泵注-γOH 100 mg.kg-1,B组泵注-γOH 50 mg.kg-1复合瑞芬太尼0.05μg.kg-1.min-1,检测注药前(T0)、注药后(T1)、下镜时(T2)、下镜后30 min(T3)时的BIS值、HR、RR、SaO2、PEtCO2、皮质醇及血糖浓度。结果A、B组患儿注药后HR、BIS、RR明显下降(P<0.05),但下镜时A组患儿HR明显上升(P<0.05),两组患儿下镜副皮质醇及血糖浓度都升高(P<0.05),以A组明显(P<0.05)。结论瑞芬太尼可抑制小儿气管异物镜检所致的应激反应,且无明显呼吸循环抑制。     

螺旋CT虚拟内诊镜在小儿气管支气管异物诊断中的应用

目的探讨螺旋CT虚拟内诊镜(CTVE)在小儿气管、支气管异物诊断上的应用价值。 方法回顾性分析东南大学医学院附属徐州医院1998年1月至2004年12月收治的121例术前经CTVE诊断为气管支气管异物，并行支气管镜探查术患儿的诊疗情况，并分析CTVE诊断在临床应用上的意义及诊断的阳性符合率。 结果121例经CTVE诊断并行支气管镜探查证实并取除异物者115例，诊断符合率9504%。 结论CTVE检查是目前无创非侵入性诊断小儿气管支气管异物的较理想方法。     

Psammocarcinoma of the ovary: a case report and review of the literature

Psammocarcinoma is a rare form of serous carcinoma of the ovary, associated with extensive psammoma body formation and invasion of surrounding structures. We report the case of a 63-year-old woman who presented with a highly calcified abdominopelvic mass and a raised CA-125 marker and who, following a full staging laparotomy, was diagnosed with stage IIIB ovarian psammocarcinoma. Serous ovarian psammocarcinoma is characterized by massive psammoma body formation, and despite the limited number of cases reported, it appears that the clinical prognosis is much more favorable than for the usual serous carcinomas and is similar to that of serous borderline lesions of the ovary. A summary of all the reported cases is provided to highlight the clinical and prognostic features of this rare tumor.     

热致相分离法制备聚醚醚酮多孔膜

对聚醚醚酮/二苯砜、聚醚醚酮/二苯酮所组成聚合物/稀释剂体系,采用热致相分离法制备了聚醚醚酮多孔膜,探讨了制备具有耐高温、耐溶剂的聚醚醚酮多孔膜的可能性,对聚合物/稀释剂体系的相容性进行理论计算和分析,并研究了聚合物的含量对成膜多孔结构的影响。     

Frontal and subcortical contribution to visual hallucinations in dementia with Lewy bodies and Parkinson’s disease

Objectives: Visual hallucinations (VH) are common in Lewy body disease (LBD), and have been associated with cognitive and structural brain alterations. Evidence so far concerns mainly Parkinson’s disease (PD), but little is known about symptom-specific pathophysiological mechanisms across the LBD spectrum, especially related to the presence of dementia. The aim of the present pilot study was to investigate the neuroanatomical, and neuropsychological characteristics related to VH in two forms of LBD, namely dementia with Lewy bodies (DLB) and PD without dementia.

Methods: Whole brain voxel-based morphometry (VBM) analyses on 3D MRI acquired structural brain scans, and neuropsychological testing were performed on 28 clinically diagnosed DLB (11 with VH, 17 NVH), and 24 PD (9 with VH, and 15 NVH) patients. In order to assess differences in gray matter (GM) regional volumes, and cognitive performance, hallucinating patients for each group were compared with corresponding non-hallucinating ones.

Results: DLB patients with VH presented significantly worse visual attention deficits compared to those without, which persisted even when controlling for visual perception. Whole brain VBM analysis revealed decreased GM volume in DLB with VH in the right superior and medial frontal gyri, putamen, caudate nucleus and insula. Subcortical regional volumes were also significantly associated with visual attention performance. Hallucinating PD patients, instead, presented more severe executive dysfunction, but VBM showed no volumetric differences between the two PD subgroups. Post hoc region of interest analyses revealed striatal GM loss in PD with VH.

Conclusion: Frontal and striatal GM atrophy may contribute to the emergence of VH in DLB, which may be fostered by the more severe attention deficits. Striatal GM loss and executive dysfunction, instead, appeared to underlie VH in PD without dementia.     

Fifty years of Weibel–Palade bodies: the discovery and early history of an enigmatic organelle of endothelial cells1

Summary. In 1962, a rod‐shaped cytoplasmic organelle of endothelial cells, later called the Weibel–Palade body, was serendipitously discovered by electron microscopy. It contains a set of parallel tubules and is wrapped in a membrane. Subsequent studies in the following decades established the unique localization of this organelle in endothelial cells of all vertebrates studied, meaning that it could serve as a marker of endothelial cells in tissue cultures. However, these studies did not reveal its functional significance, except for an indication that it could be related to an undefined thromboplastic substance. Twenty years after its discovery as a structural entity, it was shown by others that it houses von Willebrand factor and is thus clearly related to the coagulation system. In this review, I provide a personal historical account of the discovery and the subsequent limited work that I carried out on the organelle, putting it in the perspective of the current state of knowledge after half a century of research by many scientists.     

An Inexpensive and Easy Ultrasound Phantom

Ultrasound models, commonly referred to as “phantoms,” are simulation tools for ultrasound education. Commercially produced phantoms are available, but there are “homemade” alternatives such as raw poultry and gelatin molds. Precooked, processed meat, better known as SPAM (Hormel Foods Corporation, Austin, MN), can be used as an ultrasound phantom to teach several ultrasound applications. It is a versatile, hygienic, and easily manipulated medium that does not require refrigeration or preparatory work and can be easily discarded at the end of use.     

Survival time and differences between dementia with Lewy bodies and Alzheimer’s disease following diagnosis: A meta-analysis of longitudinal studies

ObjectiveTo synthesize the evidence across longitudinal studies comparing survival in dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD).MethodsWe conducted a systematic review and meta-analysis of studies comparing survival in clinically diagnosed DLB to AD. Longitudinal cohort studies were identified through a systematic search of major electronic databases from inception to May 2018. A random effects meta-analysis was performed to calculate survival time and relative risk of death.ResultsOverall, 11 studies were identified including 22,952 patients with dementia: 2029 with DLB (mean diagnosis age 76.3; 47% female) compared with 20,923 with AD (mean diagnosis age 77.2; 65.1% female). Average survival time in DLB from diagnosis was 4.11 years (SD ± 4.10) and in AD 5.66 (SD ± 5.32) years, equating to a 1.60 (95% CI: -2.44 to -0.77) years shorter survival in DLB (p < 0.01). Relative risk of death was increased by 1.35 (95%CI: 1.17–1.55) in DLB compared to AD (p < 0.01). Differences in survival were not explained by follow-up time, age at diagnosis, gender, or cognitive score.ConclusionsThere is consistent evidence for higher and earlier mortality in DLB compared to AD. This is important for all stakeholders and underlines the importance of expanding research into DLB.