Splenic nonenhancement at computed tomography: A sign of the hypoperfusion complex

When splenic nonenhancement is seen at computed tomography, one should look for signs of vascular pedicle injury; if injury to the vascular pedicle is not present, nonenhancement of the spleen could be secondary to severe vasoconstriction and may be considered an additional sign of the hypoperfusion complex. The presence of splenic nonenhancement may also help differentiate the hypoperfusion complex from other types of bowel injury.     

肠易激综合征患者结肠粘膜扫描电镜观察

应用扫描电镜观察１０例肠易激综合征（ＩＢＳ）患者降结肠粘膜的超微结构并和２例正常者进行比较性研究，结果发现ＩＢＳ组结肠粘膜上皮细胞表面微绒毛有局灶性破坏，破坏区微绒毛排列不整齐，数量稀少或缺如，结肠腺数量明显增多，腺窝开口大。腺窝处见有大量粘液分泌物和数量显著增多的杯状细胞。作者认为，ＩＢＳ并非是消化迫功能性疾病，而是有结肠粘膜超微结构改变的器质性疾病     

医院经济分配制度改革的推进思路

分配制度改革不仅是调动职工积极性的重要举措，还是卫生体制改革的重要内容，其涉及面广，政策性强，敏感度高，一直是困扰医院改革与发展的难题，也是评价医院有无活力的重要表现。     

Cr:LiSAF激光在组织自体荧光光谱研究中的应用

目的　该文以Cr:liSAF激光作为激发光源 ,针对生物大分子设计了荧光实验 ,以探讨其在组织自体荧光研究中的应用。方法　氙灯泵浦Cr:LiSAF二次谐波用来产生可调谐蓝光脉冲激光输出 ,并设计了自体荧光试验。结果　最后设计并实现了可调谐蓝光脉冲激光输出 ,得到了良好的输出特性。结论　氙灯泵浦Cr:LiSAF二次谐波产生可调谐蓝光脉冲激光输出得到了良好的输出特性 ,该实验为进一步研究肿瘤组织与正常组织自体荧光产生机制打下了基础。     

Combined large cell neuroendocrine carcinoma

We report a case of combined large cell neuroendocrine carcinoma. A 78-year-old man with vertigo was referred to our hospital where chest X-ray revealed a tumor shadow in the right lung. A transbronchial lung biopsy specimen verified a diagnosis of non-small cell lung carcinoma (cT1N0M0). Right lower lobectomy with mediastinal lymph node dissection (#7,8,9) was performed. A postoperative histological diagnosis was combined large cell neuroendocrine carcinoma of a component of squamous cell carcinoma [pT4 (pm) N2M0]. The patient received concurrent chemoradiotherapy due to upper mediastinal lymph node metastasis 4 months after surgery. The chemoradiotherapy well responded and the patient remains well 9 months after surgery.     

小鼠肠移植术前输注表达吲哚胺2,3双加氧酶的供者树突细胞抑制排斥反应

目的观察干扰素γ(IFN-γ)诱导供者(C57BL/6小鼠)脾树突细胞(DC)表达吲哚胺2,3双加氧酶(IDO)的情况;研究受者(BalB/c小鼠)小肠移植术前输注高表达IDO的供者DC对排斥反应的抑制作用。方法用IFN-γ诱导供者DC表达IDO;半定量逆转录聚合酶链反应、免疫印迹法及毛细管电泳法检测IDO表达水平及活性,混合淋巴细胞培养(MLR)测定IDO刺激T细胞增殖的能力。利用小鼠异位小肠移植模型,设单纯移植组、DC输注移植组(术前输注供者脾DC 2×10~6个)及诱导DC输注移植组(术前输注经IFN-γ诱导的供者脾DC 2×10~6个),术后观察移植肠存活时间并行病理学检查。结果经IFN-γ诱导的脾DC IDO分子mRNA转录水平(相对量)、IDO蛋白表达水平(相对量)及培养液中犬尿氨酸浓度分别为(1.23±0.02)、(2.74±0.01)以及(76.52±0.44)μmol/L,未经IFN-γ诱导的脾DC分别为(1.05±0.05)、(1.40±0.17)及(43.31±0.48)μmol/L,前者显著增强(P<0.01)。脾DC对同种T细胞增殖的刺激作用在IFN-γ诱导后减弱,在加入IDO的特异性抑制剂后增强。输注诱导DC移植组移植肠中位存活时间(12 d)较单纯移植组(6 d)及输注DC移植组(7.5 d)显著延长(P<0.01),而移植肠病理分级显著性降低(P<0.05)。结论IFN-γ可诱导小鼠脾DC高表达活性的IDO,后者可减弱DC刺激T细胞增殖的能力。受者术前输注高表达IDO的供者DC能够诱导针对供者的特异性免疫耐受而减轻排斥反应。     

Pseudotumoral appearance of small bowel strictureplasty for Crohn's disease

In two patients with Crohn's disease, strictureplasties had been marked operatively by a metal clip, so that definitive location on subsequent small bowel examination was possible. Each stricture-plasty presented radiologically as a short annular constriction with apparently shouldered edges and parallel lumen. Similar radiological features were found in five other patients with strictureplasties, suggesting that a pseudotumoral appearance is characteristic of strictureplasty. Attention is drawn to this finding to avoid confusion with malignancy.     

临床小肠移植排斥反应的防治

采用环孢素Ａ、雷公藤多甙、甲基氢化泼尼松、前列腺素Ｅ１伍用的新型免疫抑制方案，预防小肠移植排斥反应取得满意效果。病人存活３１０ｄ。经验表明，通过内窥镜和肠粘膜组织病理检查，监测排斥反应简便实用有效。利用聚合酶链反应（ＰＣＲ）技术研究发现，移植术后供肠细胞向受体组织移居嵌合，而临床无移植物抗宿主病（ＧＶＨＤ）发生。促进细胞移居嵌合可能有利于防止排斥反应的发生。     

老年人大肠息肉146例分析

对１４６例老年（＞６０岁）大肠息肉进行研究，发现：①在老年肠道疾患中大肠息肉的发生率较高，占同期结肠镜受检者的２４．３％；②息肉的组织类型以炎性息肉最多（７６．０％），其次为大肠腺瘤（１８．３％）和增生性息肉（５．７％）；③复合性息肉发生率为３０．１％，病变多累及２个以上肠段；④腺瘤癌变率达２６．９％。