Eosinophils,mast cells,nerves and ganglion cells in appendicitis

Introduction  

Twenty to thirty percent appendices removed from patients with suspected appendicitis appear normal on histology. The cause of pain in these patients is unknown. The presence of eosinophils and mast cells should be looked at skeptically which may explain the cause of pain. The aim was to study the eosinophils, mast cells, nerves and ganglions in normal and inflamed appendices.     

单操作孔胸腔镜胸顶部良性肿瘤的治疗体会

〔摘 要〕 目的：探讨单操作孔胸腔镜胸顶部良性肿瘤手术的可行性。方法：收集 2017 年 1 月至 2021 年 3 月在深圳大 学第一附属医院行单操作孔胸腔镜手术治疗的胸顶部良性肿瘤患者 7 例,分析其临床效果及并发症。结果：所有患者肿瘤 均顺利完整切除,神经鞘瘤 4 例,节细胞神经瘤 2 例,脉管瘤 1 例。手术时间 85 ~ 145 min,平均（111.3 ± 21.0）min;术 中出血量 20 ~ 50 mL,平均（37.1 ± 12.5）mL;术后引流量 80 ~ 240 mL,平均（161.4 ± 54.3）mL。2 例霍纳综合征,其 中 1 例术后 1 月逐渐减轻,1 年后随访部分功能恢复,另 1 例术前即有霍纳综合征,而术后病情加重,1 年后随访无缓解; 2 例术侧上肢疼痛、麻木及活动受限,锻炼及理疗后逐渐缓解。无其它并发症发生。结论：单操作孔胸腔镜手术对经挑选的 胸顶部良性肿瘤病例,创伤小、安全、有效。     

亚甲蓝用于腰交感神经节阻滞

目的 :观察亚甲兰在腰交感神经节阻滞术中应用的可能性并评估其治疗效果。方法 :33例腰腿部血管性或交感反射性疼痛患者 ,行第二腰椎旁交感神经节阻滞 ,给予小剂量、低浓度亚甲兰。结果 :(1)VAS评分治疗后明显低于治疗前 (P <0 .0 1) ,总有效率达 93.9%。 (2 )情绪评分治疗后明显低于治疗前 (P <0 .0 1)。结论 :小剂量低浓度的亚甲蓝可用于腰交感神经节阻滞术 ,具有良好的止痛效果。     

Analysis of the retinal nerve fiber and ganglion cell – Inner plexiform layer by optical coherence tomography in Parkinson’s patients

AimTo measure and evaluate the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) in patients with Parkinson’s disease using optical coherence tomography (OCT).Methods58 eyes of 30 patients with Parkinson’s disease and 60 eyes of 30 healthy individuals were enrolled to this study according to defined criteria. RNFL thickness, central macular thickness (CMT) and ganglion cell-inner plexiform layer (GC-IPL) thickness were measured in these groups. The Parkinson’s patient group was also subjected to Unified Parkinson’s Disease Rating Scale (UPDRS) and Mini Mental Status Exam (MMSE).ResultsNo difference was found between the two groups with respect to age, sex and the best corrected visual acuity (BCVA). Mean, superior, and inferior quadrant RNFL values in the Parkinson’s patients were found statistically significantly lower than those in the control group (P < 0.001, P < 0.049, P < 0.001, respectively). While CMT was statistically similar between the groups, GC-IPL thickness was statistically significantly lower in Parkinson’s patients (p = 0.028). There was no significant correlation between the duration of Parkinson’s disease and RNFL thickness. While there was not any correlation between UPDRS total and motor scores and superior and temporal quadrant RNFL thicknesses, a significant negative correlation was established between RNFL nasal, inferior quadrant and RNFL mean thicknesses (P = 0.022; P = 0.035; P = 0.002, respectively). A significant positive correlation was found between MMSE and nasal and mean RNFL thicknesses (P = 0.046; P = 0.019, respectively).ConclusionRNFL and GC-IPL thicknesses were found lower in Parkinson’s patients. These parameters may be useful to evaluate neurodegeneration and to monitorize neuroprotective therapies.     

星状神经节阻滞联合颈2椎旁阻滞治疗颈源性头痛

目的：探讨星状神经节阻滞联合颈2椎旁阻滞治疗颈源性头痛的临床疗效。方法：56例颈源性头痛患者随机分为星状神经节阻滞联合C2横突阻滞组（A组）和星状神经节阻滞联合外周神经阻滞组（B组）,每组28例。治疗3周后采用简化McGill疼痛问卷表评估疼痛程度来评定临床疗效。结果：与治疗前比较,两组治疗后疼痛评估指数（pain rating index,PRI）、疼痛强度指数（present pain index,PPI）、视觉模拟评分（visual analogue scale,VAS）均降低（P〈0.05）。治疗后,A组PRI、PPI、VAS评分均较B组为低,治愈率较B组为高（P〈0.05）。结论：应用星状神经节阻滞联合颈2横突及后支阻滞及联合外周神经阻滞治疗颈源性头痛均有疗效,但前者疗效明显优于后者。     

星状神经节阻滞联合中药治疗偏头痛

目的观察星状神经节阻滞联合中药治疗偏头痛的临床效果。方法选择明显偏头痛患者80例,随机分治疗组和对照组;治疗组在星状神经节阻滞下,配合中药天麻钩藤饮加减治疗,对照组仅采用中药。结果随访6个月治疗组总有效率97．8％（43／44例）,无效1例,对照组总有效率63．9％（23／36例）;无效13例,两组临床效果差异有统计学意义（P〈O．05）。结论在星状神经节阻滞下,配合中药天麻钩藤饮加减治疗偏头痛,具有较高的安全性及较好的疗效,明显优于单纯中药治疗。     

星状神经节阻滞联合局部注射治疗颞下颌关节功能紊乱综合征30例临床报告

目的 观察星状神经节阻滞联合局部注射治疗颞下颌关节紊乱综合征的疗效.方法 选择症状典型患者60例,随机分为两组.A组为治疗组,星状神经节阻滞联合局部注射治疗.B组为对照组,采用电针针刺治疗.结果 A组治愈26例,有效3例,无效1例,治愈与有效率96.7%;B组治愈12例,有效9例,无效9例,治愈与有效率70%.结论 星状神经节阻滞联合局部注射治疗颞下颌关节紊乱综合征是一种较单纯电针针刺更有效的方法.     

An anatomically based imaging sign to detect adventitial cyst derived from the superior tibiofibular joint

The origin for complex intraneural cysts remains controversial despite recent emerging evidence to support their articular origin. The coexistence of intraneural and adventitial cysts has been described due to the proximate neurovascular bundle, i.e., the articular (neural) branch and vessels at the joint capsule. To clarify the pathogenesis, anatomically based imaging patterns can be identified. This paper characterizes a common finding identified on MRI describing the adventitial component originating from the superior tibiofibular joint (STFJ). MRIs of patients with fibular (peroneal) (n = 24) and tibial (n = 7) intraneural ganglion cysts were reviewed. Eleven patients with fibular intraneural ganglion cysts were identified as having a coexisting adventitial component. In all cases, the adventitial cyst extended from the anterior portion of the STFJ, within the capsular vessels, and along the anterior tibial vessels. The reproducible anatomy permitted the identification of an imaging pattern: the "vascular U" sign, consisting of cystic anterior tibial vessels running through the interosseous membrane between the proximal tibia and fibula. This sign was seen on axial MR image(s) obtained at the level of the fibular neck in all cases. To generalize these findings, the rare tibial intraneural ganglion cysts (derived from the posterior aspect of the STFJ) were examined; two cases had coexisting adventitial cysts with visualization of the vascular U sign. This new imaging pattern can improve the identification of adventitial cysts at the level of the STFJ.     

Hypogenesis of intramural vascularity and perivascular plexuses of gallbladder in patients with congenital biliary dilatation

Background  We hypothesized neuronal disorders of the biliary tract as the cause of congenital biliary dilation (CBD). Methods  Gallbladders were removed from a total of 15 patients who were categorized into two study groups: a CBD group (eight patients) and in a control group (neuroblastoma, acute myelogenous leukemia, wandering gallbladder, Wilms’ tumor, glycogen storage disease, familial amyloid polyneuropathy; seven patients). Whole-mount preparations of the gallbladders were made to immunostain the intramural nerves. Results  The intramural vascularity in the gallbladders of the CBD group (5.5 ± 1.9/cm²) was significantly lower than that in the control group (27.6 ± 14.4/cm²). The rate of perivascular plexuses on the surface of intramural vessels was also significantly lower in the CBD group than in the controls (37.7 ± 18.1 vs. 80.2 ± 17.4%, respectively). The numbers of ganglion cells per visual field were 38.5 ± 24.0 and 42.3 ± 20.6, respectively, in the CBD and control groups; this difference was not statistically significant. Conclusions  There may be a mechanism in CBD causing contractile failure and dilatation of the biliary tract as a result of decreased intramural blood flow that accompanies the diminished vascularity.     

Lumbar synovial cyst in a adolescence: case report

Background  Spinal extradural cysts are a rare cause of spinal cord or nerve root compression which tends to occur in the elderly but rarely reported in the under 20s. History  A 14-year-old girl with a 9-month history of left radicular pain was found to have an intraspinal cystic lesion causing radicular compression. Magnetic resonance imaging showed a 1.1-cm extradural cystic lesion with a low signal on T1-weighted images and high signal on T2-weighted images lying in the spinal canal at the L4 vertebral body level. The patient underwent an L4 hemilaminectomy and excision of a synovial cyst, and the radicular pain completely regressed. Discussion  We discuss the pathogenesis, radiological techniques and management of synovial cyst in a paediatric patient Conclusion  Intraspinal ganglion cysts are extremely rare in children and only two other cases have been reported previously. They are benign lesions, frequently presenting radiculopathy, and should be considered in the differential diagnosis in patients with low back pain and radiculopathy.