以眶尖综合征为首发临床表现的鼻咽癌一例

患者,男,60岁,因“头痛20余天、右眼视力下降5 d及睁眼困难3 d”于2019年3月20日就诊于暨南大学附属第一医院眼科门诊。患者多年前诊断为鼻窦炎,长期头痛伴鼻塞未行治疗。此次就诊前20 d无明显诱因出现右侧颞部头痛,疼痛持续无缓解,1周前于暨南大学附属第一医院耳鼻喉科就诊行鼻咽部肿物活检,病理结果示:镜下见小片鳞状上皮及少量炎性渗出物和凝血块。5 d前突然出现右眼视力下降,3 d前右眼出现睁眼困难,未予治疗。     

持续负压封闭引流在创伤外科中的应用

目的探讨持续负压封闭引流治疗严重污染创面的疗效。方法使用Vacuseal(威克伤)材料和生物透性薄膜对6例感染严重的创伤部位行持续负压封闭引流。结果5例病人持续负压引流5～7天后，创面经植皮或直接缝合愈合；1例每5—10天更换Vacriseal材料8次后，创腔变浅改为普通换药，7天后愈合。结论持续负压封闭引流不仅具有引流通畅、不易堵塞管腔的优点，而且还能及时清除引流区渗出物和坏死组织，改善局部微循环和促进组织水肿消退，刺激肉芽组织生长，加速创面愈合。     

碘伏治疗烧伤387例疗效分析

碘伏外用治疗烧伤，无刺激性，创面渗出物少，结痂快，感染发生率低，有利于促进创面愈合。我院自2001年起应用0．5％碘伏治疗烧伤创面387例，取得了良好的效果。现报道如下。     

E-cadherin and calretinin as immunocytochemical markers to differentiate malignant from benign serous effusions

AIM: To investigate the expressions of E-cadherin and calretinin in exfoliated cells of serous effusions and evaluate their values in distinguishing malignant effusions from benign ones. METHODS: Fresh serous effusion specimens were centrifuged and exfoliated cells were collected. Cells were then processed with a standardized procedure, including paraformaldehyde fixation, BSA-PBS solution washing and smears preparation. E-cadherin and calretinin were detected by immunocytochemistry (ICC). RESULTS: In the exfoliated cells of serous effusions, most of carcinoma cells only expressed E-cadherin, and most of mesothelial cells only expressed calretinin, and benign cells (lymphocytes and granulocytes) did not express either of them. For E-cadherin, 85.7% (30/35) of malignant effusions and 8.1% (3/37) of benign fluids were ICC-positive (P<0.001). The sensitivity of E-cadherin ICC in the diagnosis of malignant effusions was 85.7%, specificity 91.9%, and diagnostic rate 88.9%. For calretinin, 94.6% (35/37) of benign effusions and 11.4% (4/35) of malignant effusions were ICC-positive (P<0.001). The sensitivity of calretinin ICC in the diagnosis of benign effusions was 94.6%, specificity 88.6%, and diagnostic rate 91.7%. For diagnosis of benign and malignant effusions by combining E-cadherin ICC and calretinin ICC, the specificities were up to 100% and 97.1%, respectively. CONCLUSION: E-cadherin ICC and calretinin ICC are sensitive and specific in differential diagnosis of benign and malignant serous effusion specimens and specificities are evidently improved when both markers are combined.     

一叶知秋：“哨兵”签发肿瘤“追捕令”

据报道，一种简便、高效的肿瘤初筛试剂日前在北京问世。只要你用棉签刷一下鼻毛，然后在棉签上滴一点试剂，根据颜色变化就能判断出是否有癌症。其理论根据是。当人体出现肿瘤时，人体的基因、细胞、组织、器官等都会出现一定程度的损伤。这时，体内的空腔脏器黏膜极易受到肿瘤细胞侵袭而受损，受损后的黏膜就会有极微量的反应渗出物。而鼻黏膜则是一个重要而方便取材的参考原料。     

慢性肥厚性咽炎的微波治疗

慢性肥厚性咽炎是耳鼻喉科常见病、多发病，又称慢性粒性咽炎及咽侧炎，病变表现为黏膜及黏膜下较广泛的结缔组织增生及淋巴组织增生，在黏液腺周围的淋巴组织增生突起，咽后壁上表现为多数颗粒状隆起，呈慢性充血状，有时甚至融合成一片，黏液腺内的炎性渗出物被封闭其中，在淋巴颗粒隆起的顶部形成囊状白点，破溃时可见黄色渗出物。此型咽炎常累及咽侧索淋巴组织，使其增生肥厚，[第一段]     

速效牛黄丸临床应用举隅

张××,女,10岁,小学生,1987年10月5日初诊。7年前,头部出现红斑伴小丘疹,而后迅速扩展,并有渗出液,屡治罔效。现见头部皮肤肥厚,小片状红斑,色黯,两颞部脱鳞屑,枕、顶部红斑色鲜红,互相融合,境界不清,斑上见小水疱及糜烂,直径约1.5毫米,大量浆液外溢,渗出物干后之黄痂与头发粘连在一起,毛发稀疏,痒痛同现,体胖面赤便干,     

肛周巨大尖锐湿疣激光治疗切除一例

患者,男,78岁,肛周肿物1年。1年前发现肛周有赘生物,伴潮湿瘙痒,曾自行按痔疮治疗,外用马应龙麝香痔疮膏3个月治疗,疗效不佳。半年来肿物逐渐增大,排便受限,湿痒症状加重,同时伴有疼痛、渗出物增多。     

遇阑尾切除困难时的一些体会

资料与方法 2001年来共做313例阑尾切除术,对其中行常规阑尾切除困难的31例病人运用逆行“抽芯”技术切除阑尾,其中男20例,女11例,年龄14～70岁。阑尾炎类型：①阑尾与阑尾系膜、回肠、盲肠、大网膜等形成一个纠缠不清的“炎症块”,无法清楚辨认阑尾15例。②由于慢性炎症反复发作,炎性渗出物纤维变性,将阑尾牢固沾附在盲肠壁或后腹膜上9例。③由于阑尾坏疽或穿孔,阑尾在分离过程中断为两截,而阑尾远端游离困难者5例。④盲肠后或后腹膜外阑尾炎2例。