青年人大肠癌误诊原因探讨

目的 探讨青年人大肠癌的误诊原因，以便早期诊断治疗。方法 回顾性分析62例青年人大肠癌的诊断及其治疗效果。结果 本组直肠癌36例中被误诊为结肠炎7例，痔疮并出血5例，痢疾3例，肛周脓肿并肛瘘2例；结肠癌26例中被误诊为阑尾周围脓肿3例，结肠炎2例，缺铁性贫血1例。误诊率37．1％。结论 青年人大肠癌早期临床症状不明显，恶性程度高，预后差,其治疗水平有赖于对这些特征的认识，力争早期诊断及治疗。     

A new monoclonal antibody which binds to the cytoplasm of large cell lymphomas.

We reported a new monoclonal antibody, designated FUB-1, reacting with normal and neoplastic large lymphoid cells. FUB-1 was produced using a Burkitt's lymphoma cell line (HBL-5) as an immunogen. Its immunoglobulin subtype was IgM. The determinant was not on the surface but in the cytoplasm. Western blotting analysis revealed that the molecular weight of the antigen was 52,000 dalton. In the normal lymphoid tissue, FUB-1 reacted with large lymphoid cells, but not with small or medium-sized lymphoid cells or plasma cells. In addition, the FUB-1 antigen was not found in resting cells in the peripheral blood (PB), but it was induced on mononuclear cells of PB by addition of PWM or PMA. In the B-cell lymphomas tested, FUB-1 reacted with small cleaved cell lymphomas (3/12), large cell lymphomas (7/10), Burkitt's lymphomas (4/4) and immunoblastic lymphomas (2/2), but not with small cell lymphomas (0/3) or intermediate lymphocytic lymphomas (0/8). These findings indicate that the FUB-1 antigen appears to be expressed on normal lymphoid cells during blastoid transformation and on neoplastic large lymphoid cells. FUB-1 also reacted with normal glandular epithelium and various adenocarcinomas. FUB-1 may be useful to investigate the mechanism of in vitro blastoid transformation or activation of lymphoid cells.     

Effect of L(+)-tartrate on some biochemical and enzymatic parameters in normal and glycollate treated rats

Some biochemical and enzymatic constituents were determined in the small intestinal tract tissues of normal and sodium glycollate treated adult male rats. Alterations were observed with respect to certain lipids and carbohydrate fractions in the glycollate fed rats. DNA content was also elevated in this group. The functions of the cell membrane is likely to be affected as reflected in the levels of transport ATPases and orthophospho-hydrolases. The activities of the two marker enzymes in the intestinal brush border, namely alkaline phosphatase and leucylnaphthylamidase were reduced in the glycollate administered group. Administration of L(+)-tartrate, which is a mild laxative and has a regulatory influence on oxalate metabolism, lowered the activities of Na+, K(+)- and Ca(2+)-ATPases. There was a distinct lowering in the level of acid phosphatase in the tartrate treated rats.     

Localization of small intestinal bleeding

The preoperative identification of a bleeding site is not always possible, particularly when bleeding originates in the small intestine. Small vascular abnormalities, such as the telangiectatic lesion described in this report, comprise about 40–60% of such cases. Preoperative location using arteriography, radionuclide bleeding scan, and enteroclysis were nondiagnostic. The lesion was demonstrated by intraoperative endoscopy. A segment of small intestine was resected, and the patient made an uneventful recovery.     

口服法小肠气钡双对比造影对小肠疾病的影像诊断

目的:探讨口服法小肠双对比造影检查及病变表现特点。方法:辅以高、低张药物,口服80%(w/v)硫酸钡200ml加经肛门逆行注入空气2000ml进行小肠双对比造影检查,显示双对比小肠影像。结果:147次小肠造影检查中118例成功地用该方法进行小肠双对比造影检查,成功率80.27%,年龄14岁至69岁,平均34.3岁。118例中阳性32例,阳性显现率27.12%,病理证实的25例,占阳性病例的78.13%。不能应用高、低张药物和逆行注气失败的共29例,占19.73%。小肠肿瘤、Crohn's病、Meckel's憩室和回肠末段淋巴滤泡增生症小肠疾病的双对比影像具有特征性表现。结论:(1)此法小肠双对比造影检查简便易行,适合各类有电视X线机的放射科开展。(2)小肠病变在双对比影像上表现特征明显,易于诊断。(3)不能应用高、低张药物和肛门括约肌松弛的患者用此法检查将受到限制。     

Neuronal adrenergic and muscular cholinergic contractile hypersensitivity in canine jejunum after extrinsic denervation

Extrinsic denervation may be responsible for motor dysfunction after small bowel transplantation. The aim of this study was to examine the role of extrinsic innervation of canine jejunum on contractile activity. An in vitro dose response of cholinergic and adrenergic agonists was evaluated in canine jejunal strips of circular muscle at 0, 2, and 8 weeks in a control group and after jejunoileal extrinsic denervation (EX DEN). Neurons in circular muscle were quantitated by means of immunohistochemical techniques. Adrenergic and cholinergic responses did not differ at any time in the control group. However, at 2 and 8 weeks, extrinsic denervation caused an increased sensitivity to the procontractile effects of the cholinergic agonist bethanechol at the level of the smooth muscle cells, and increased sensitivity to the inhibitory effects of the adrenergic agent norepinephrine mediated at the level of the enteric nervous system. Immunohistochemical analysis showed a reduction in all neurons and a complete lack of adrenergic fibers in the EX DEN group after 2 and 8 weeks. Extrinsic denervation induces enteric neuronal cholinergic and adrenergic smooth muscle hypersensitivity in canine jejunal circular muscle. Presented in part at the annual meeting of the American Gastroenterological Association, Orlando, Florida, May 18, 1999 (poster presentation), and published as an abstract in Gastroenterology 116:A1075, 1999. Supported by United States Public Health Service grant DK39337 from the National Institutes of Health (M.G.S.); the Swiss National Science Foundation; the Swiss Society of Gastroenterology and Hepatology; the Swiss Foundation for Medical and Biological Science; the Novartis Foundation; Astra Zeneca Pharmaceuticals, Switzerland; and the Department of Visceral and Transplantation Surgery, University of Bern, Switzerland.     

原发性小肠肿瘤诊断治疗的临床分析(附58例报告)

目的探讨原发性小肠肿瘤临床特型、病理分型及诊治经验。方法回顾性分析1993年10月。2003年10月收治的有完整资料的58例原发性小肠肿瘤病例。结果本组包括13例(22．4％)良性肿瘤，45例(77．6％)。小肠良性肿瘤均行局部肠段切除，除2例死于其它疾患外，余11例健在；小肠恶性肿瘤患者中，院内死亡6例，仅11例能行根治性肠切除，37例行化疗(总有效率83．4％)，随访33例(随访率89．5％)，存活5年以上者14例(5年生存率42．4％)，多为T细胞性非何杰金淋巴瘤。结论原发性小肠肿瘤恶性所占比例较高，缺乏特征性的临床表现及有效的诊断手段，易致长期延误诊治，预后甚差；对原因不明的腹痛、消化道出血及定位不明的腹部包块患者及早行剖腹探查是避免小肠肿瘤长期误诊、改善患者预后的可靠手段。     

严重烧伤后肠道损伤与肠源性高代谢的关系

目的　探讨烧伤后肠道损害与“肠源性高代谢”的关系。方法　在建立严重烧伤加清洁肠道动物模型的基础上 ,将 96只Wistar大鼠随机分为烧伤对照 (B)组和烧伤加清洁肠道 (SDD)组。观察了伤后 0～ 10d大鼠静息能量代谢率(REE)的变化 ,同时检测了伤后 0、1、3、5、7、10d血中内毒素 (LPS)、肿瘤坏死因子 (TNF)和二胺氧化酶 (DAO)的含量 ,并进行相关分析。结果　烧伤后两组大鼠的REE、TNF、LPS和DAO均明显高于伤前 ,两组相比 ,SDD组的REE、TNF和LPS较B组均有不同程度的降低 ,而DAO则明显高于B组。相关分析显示 ,REE同LPS和TNF呈显著正相关 (r1 =0 .77,P <0 .0 5 ,r2 =0 .81,P <0 .0 5 ) ,与DAO相关不显著 (r >0 .0 5 )。结论　烧伤后肠源性高代谢与血中炎症介质含量呈正比 ,但肠道损伤程度加重并不引起代谢率相应增加 ,二者不存在线性关系     

急性缺血性卒中大血管闭塞性质的判断与取栓方式和材料的选择

血管内机械取栓是治疗大血管闭塞性急性缺血性卒中的有效治疗方法。应结合病史、发
病形式及影像学检查等综合判断病变性质；依据病变性质并参考手术路径，个性化选择支架取栓、
抽吸取栓、球囊/支架血管成形术、动脉溶栓任一种或多种方法联合取栓；并依据手术方式选择手
术材料，以快速高效地完成手术。     

原发性小肠肿瘤60例临床分析

目的 探讨原发性小肠肿瘤的临床特点和诊查方法。方法 回顾性分析60例原发性小肠肿瘤的临床资料、发病特点及术前诊查方法。结果 小肠肿瘤临床表现不特异，确诊时长达1周-32个月，平均6个月。术前确诊率低（31．7％）。检查方法中胃肠造影和CT的使用相对较多，受检阳性率分别为54．2％（26／48）和81．3％（26／32）。小肠肿瘤恶性居多，占53．8％（21／39）。结论 原发性小肠肿瘤表现隐匿，容易误诊，常规检查手段特异性不高，胃肠造影和CT确诊率相对较高，新的检查方法有待开发。