ObjectiveTo introduce the advances in diagnosis and treatment of superior mesenteric artery syndrome (SMAS). MethodsLiteratures about SMAS published in domestic and abroad were collected and reviewed. ResultsSMAS was a rare medical condition characterized by acute or chronic ileus resulting from vascular compression of the third part of the duodenum by superior mesenteric artery. Images of upper gastrointestinal series, CT, MRI, and color Doppler ultrasonography were the major methods of diagnosing the syndrome and the upper gastrointestinal series was the most important. Conservative approaches were usually preferred to the treatment of SMAS. Surgery was performed on symptomatic patients when conservative treatment failed, and duodenojejunostomy was the best surgical procedure. ConclusionAwareness of the clinical and imaging features may be helpful to diagnosis and treatment of SMAS, and reasonable therapy shall include etiological treatment and relief of the obstruction by conservative treatment or surgery.
目的:探讨电击伤的临床特征,手术治疗及疗效。方法:对78例电击伤患者的临床资料进行分析。结果:电击伤多为工伤,病情重,常常多次手术,住院时间长,致残率高。结论:早期积极、延迟的手术,功能可得到最大的恢复,截肢率降低,预后较好;电击伤创面修复以皮瓣、肌皮瓣转移的手术方式效果为佳。
Objective To study the significance of the levels of plasma inflammatory cytokines (IL-6,IL-8,IL-10 and TNF-α) in patients with acute deep venous thrombosis (DVT) of lower extremity. Methods Forty untreated DVT cases were selected as the subjects in the DVT group, while thirty healthy subjects, whose ages and genders showed no significant difference with the DVT patients, were collected as the control group. The plasma levels of IL-6, IL-8 and TNF-α were detected by radioimmunoassay (RIA), and the plasma level of IL-10 was measured by enzyme-linked immunosorbent assay (ELISA). Correlation analysis was used to investigate the relationships between the levels of different inflammatory cytokines within DVT group. Results The levels of plasma cytokines in the DVT group were all significantly higher than those in control group (P<0.001). The results of the correlation analysis showed that there were positive correlations between IL-6 and TNF-α (r=0.383, P<0.05), IL-10 and TNF-α (r=0.390, P<0.05), respectively, within the DVT group; whereas there were no correlations between IL-6 and IL-8, IL-6 and IL-10, IL-8 and IL-10, and IL-8 and TNF-α. Conclusion The levels of plasma cytokines increased significantly in patients of DVT. Inflammatory cytokines may play an important role in acute DVT by accelerating the pace of thrombosis, intensifying the inflammatory reaction around thrombus and aggravating the injured blood vessel.
Objective To investigate the recent studies about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm. Methods The current literatures about the relationship between Chlamydia pneumoniae and abdominal aortic aneurysm were reviewed. Results Chlamydia pneumoniae is one of the most important factors for the formation of abdominal aortic aneurysm since Chlamydia pneumoniae can cause abdominal aortic aneurysm through the metabolism of matrix metalloproteinases, the apoptosis of smooth muscle cells in the vessels and the chronic infection of the wall of the aneurysm. Conclusion There maybe a distinguishingly close relationship between Chlamydia pneumoniae and abdominal aortic aneurysm, and Chlamydia pneumoiae may take an important role in the development and progress of the abdominal aortic aneurysm.
目的探讨胃肠道间质瘤(GISTs)的临床表现、病理特点及诊断、治疗和预后。方法回顾性分析2002年1月至2004年3月期间收治的21例GISTs患者的临床和病理资料。结果主要临床表现为腹部不适或疼痛、消化道出血、腹部包块和贫血。术前无一例确诊。均接受手术治疗,术中均未见淋巴结肿大转移。肿瘤直径<5 cm者有9例,5~10 cm者有 9例,>10 cm者3例。常规病理检查见梭形细胞,最终依靠免疫组化染色确诊。良性5例,低度恶性14例,恶性2例; 免疫组化检测CD117阳性18例,CD34阳性13例,而CD117阳性和(或)CD34阳性20例。随访3~30个月,平均11.5个月,随访率为100%,1例于术后13个月死亡,1例术后7个月出现肝转移,其余均无瘤生存。结论GISTs术前确诊非常困难,病理检查时发现非上皮性的梭形细胞肿瘤应作常规免疫组化染色以确诊,手术切除为主要治疗方法。
Objective To investigate the effects of chitosan/polyvinyl alcohol (PVA) nerve conduits for repairing radial nerve defect in Macaques. Methods Twelve adult Macaques weighing 3.26-5.35 kg were made the models of radial nerve defect (2 cm in length) and were randomly divided into 3 groups according to nerve grafting, with 4 Macaques in each group. Chitosan/PVA nerve conduit, non-graft, and autografts were implanted in the defects in groups A, B, and C, respectively. And the right radial nerves were used as normal control. At 8 months postoperatively, the general observation,electrophysiological methods, and histological examination were performed. Results At 8 months postoperatively, theregenerated nerve bridged the radial nerve defect in group A, but no obvious adhesion was observed between the tube and the peripheral tissue. The regenerated nerve had not bridged the sciatic nerve defect in group B. The adhesions between the implanted nerve and the peri pheral tissue were significant in group C. Compound muscle action potentials (CMAP) were detected in group A and group C, and no CMAP in group B. Peak ampl itude showed a significantly higher value in normal control than in groups A and C (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). Nerve conduction velocity and latency were better in normal control than in groups A and C, and in group C than in group A, all showing significant differences (Plt; 0.05). The density of myl inated fibers in groups A and C was significantly lower than that in normal control (P lt; 0.05), but there was no significant difference between groups A and C (P gt; 0.05). The diameter and the myel in sheath thickness of the myl inated fibers in normal control were significantly higher than those in groups A and C, and in group C than in group A, all showing significant differences (P lt; 0.05). Conclusion The chitosan/PVA nerve conduits can promote the peripheral nerve regeneration, and may promise alternative to nerve autograft for repairing peripheral nerve defects.